Individual
MICHAEL F OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1833 2ND AVE S-MAIL STOP 39300A, RIVERWAY CLINIC - ANOKA, ANOKA, MN 55303-2432
(763) 587-4400
(763) 587-4205
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5375
(763) 587-4205
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25200
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
698002300
—
MN
Enumeration date
02/16/2006
Last updated
12/01/2011
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