Individual
STEPHEN J OTERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
129 EL PASO ROAD, LCMC WHITE MOUNTAIN MEDICAL ASSOCIATES, RUIDOSO, NM 88345
(575) 630-8350
(575) 257-4055
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2003-0049
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17351235
—
NM
Enumeration date
10/03/2006
Last updated
08/15/2008
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