Individual
DR. MICHAEL WILLIAM OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
55 FRUIT STREET, WAC 812 MASSACHUSETTS GENERAL HOSPITAL, BOSTON, MA 02114
(617) 726-3488
(617) 726-7541
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4871
MA
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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