Otterson, Mary

Otterson, Mary is an individual health care provider with primary practice located at Froedtert & Med College Clin - West 9200 West Wisconsin Avenue, Milwaukee WI 53226. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Otterson, Mary can be contacted via phone (414) 805-3666.

Contact Information

Primary practice address
Froedtert & Med College Clin - West 9200 West Wisconsin Avenue Milwaukee WI 53226
Phone: (414) 805-3666
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 27051 Wisconsin

Profile Details

NPI number 1255385001
LBN Legal business name Otterson, Mary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255385001 NPPES
Wisconsin MEDICAID 31590300

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