Individual
RONNY M. OTERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6450
(414) 955-0082
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6450
(414) 955-0082
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
76231
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010H262530
BLUE CROSS-BLUE CROSS
—
05
—
458069810
—
MI
01
—
RO069663
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
11/17/2006
Last updated
10/22/2021
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