Individual
MRS. TESSIE OTERO-TRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2232 WILBORN AVE, STE B, SOUTH BOSTON, VA 24592-1662
(434) 575-5844
(434) 575-0862
Mailing address
2232 WILBORN AVE, STE B, SOUTH BOSTON, VA 24592-1662
(434) 575-5844
(434) 575-0862
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101052342
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006082807
—
VA
01
—
281110
ANTHEM
VA
01
—
44141
OPTIMA
VA
Enumeration date
06/16/2005
Last updated
01/14/2016
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