Individual
DR. THEODORE IKECHUKWU OTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1035 BELLEVUE AVE STE 315, RICHMOND HEIGHTS, MO 63117-1856
(314) 683-6110
(314) 485-2136
Mailing address
PO BOX 4031, CHESTERFIELD, MO 63006-4031
(314) 577-5778
(636) 939-1629
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
103005
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208601823
—
MO
Enumeration date
08/14/2006
Last updated
07/21/2022
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