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Individual

CHRISTOPHER E OTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2603 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-5110
(651) 600-3035
(651) 348-8783
Mailing address
2603 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-5110
(651) 600-3035
(651) 348-8783

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
48815
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13783
DEAN
WI
05
34518300
WI
01
390807236CQ
UNITY
WI
01
392787907005
BLUE CROSS
WI
01
P00152829
RAILROAD MEDICARE
WI
01
WI01R8
JOHN DEERE
WI
Enumeration date
11/15/2005
Last updated
06/23/2020
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