Individual
MIRA OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
(734) 845-5500
Mailing address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
(734) 845-5500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301105094
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2014
Last updated
03/10/2026
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