Individual
RICHARD FRIEDRICH OTTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11108 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1730
(260) 266-5700
(260) 266-5920
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01062388A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
01062388A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641093
ANTHEM
IN
05
—
200898120
—
IN
05
—
2842026
—
OH
01
—
P00633401
RR
IN
01
—
P00823546
R.R. MEDICARE
IN
01
—
P00831352
RAILROAD MEDICARE
IN
Enumeration date
03/19/2008
Last updated
06/03/2025
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