Organization
INFECTIOUS DISEASES ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL OTTO M.D. (PRESIDENT)
(734) 712-8600
Entity
Organization
Contact information
Practice address
5333 MCAULEY DR, R3106, YPSILANTI, MI 48197-1014
(734) 712-8600
Mailing address
5333 MCAULEY DR, R3106, YPSILANTI, MI 48197-1014
(734) 712-8600
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
029166
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1046837
—
MI
Enumeration date
05/26/2006
Last updated
07/07/2010
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