Individual
DAVID THOMAS OTTENBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1445 SHELDON RD, SUITE 201, GRAND HAVEN, MI 49417-2480
(616) 846-8540
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301047511
MI
Other
Enumeration date
06/01/2005
Last updated
01/24/2012
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