Individual
DAVID JAMES OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
18131
NC
2085U0001X
Diagnostic Ultrasound Physician
18131
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186354000
—
WV
01
—
4477973
AETNA
NC
01
—
5568
PARTNERS
NC
01
—
64185
MEDCOST
NC
01
—
64374
BCBS
NC
05
—
7252277
—
VA
05
—
8964374
—
NC
05
—
Q18131
—
SC
Enumeration date
12/01/2005
Last updated
10/08/2010
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