Individual
DR. OLGA MARIE OTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 716-2255
Mailing address
PO BOX 602598, WAKE FOREST UNIVERSITY HEALTH SCIENCES, CHARLOTTE, NC 28260-2598
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2006-00712
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023365B
MEDICARE - WFUHS
NC
05
—
5910899
—
NC
Enumeration date
12/22/2005
Last updated
09/12/2011
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