Individual
THOMAS A OTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17005 OLD ORCHARD RD, LEWES, DE 19958-4828
(302) 644-3311
(302) 644-3300
Mailing address
211 EXECUTIVE DR STE 11, NEWARK, DE 19702-3358
(302) 451-6913
(302) 368-7756
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C10008890
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346240876
COMMUNITY HEALTH PLAN
—
05
—
1346240876
—
DE
01
—
264933
UNISON HEALTH PLAN
—
01
—
3692762000
AMERIHEALTH
DE
01
—
4056337
AETNA US HEALTHCARE
DE
01
—
510370286
PERDUE FARMS, INC.
DE
01
—
510370286
ONE NET PPO
—
01
—
P00712879
RAILROAD MEDICARE
—
Enumeration date
07/27/2005
Last updated
02/15/2019
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