Individual
CHARLTON GRAHAM OTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3040
Mailing address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
1629655881
IL
2084N0400X
Neurology Physician
Primary
MD488691
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/25/2021
Last updated
01/26/2026
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