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Individual

TODD OTTESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11100 EUCLID AVE, LAKESIDE, ROOM 4527, CLEVELAND, OH 44106-1716
(216) 844-3002
(216) 201-4667
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35.120989
OH
207Y00000X
Otolaryngology Physician
MD424615
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2658799
OH
01
35.120989
LICENSE
OH
Enumeration date
05/23/2006
Last updated
07/02/2013
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