Individual
DR. JOHANN PHILIPP OTHMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
802 NEW HOLLAND AVE STE 100, LANCASTER, PA 17602-2288
(717) 560-3782
(717) 560-3787
Mailing address
802 NEW HOLLAND AVE STE 100, LANCASTER, PA 17602-2288
(717) 560-3782
(717) 560-3787
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD063511L
PA
2084P0804X
Child & Adolescent Psychiatry Physician
MD063511L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018120820003
—
PA
01
—
040270
MEDICARE PIN
PA
01
—
MD063511L
MEDICAL LICENSE
PA
Enumeration date
10/02/2006
Last updated
11/15/2019
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