Individual
SCOTT C OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036109065
IL
208600000X
Surgery Physician
Primary
DR.0066919
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109065
—
IL
05
—
9000199569
—
CO
Enumeration date
09/08/2005
Last updated
01/14/2022
Update your record
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