Otto, Andrew T

Otto, Andrew T is an individual health care provider with primary practice located at 200 Patewood Dr Ste C100 , Greenville SC 29615-6322. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Otto, Andrew T can be contacted via phone (864) 454-7422.

Contact Information

Primary practice address
200 Patewood Dr Ste C100 Greenville SC 29615-6322
Phone: (864) 454-7422
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 843 South Carolina

Profile Details

NPI number 1093726648
LBN Legal business name Otto, Andrew T
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Apr 20th, 2017 - about 9 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 1093726648 NPPES
South Carolina MEDICAID 0313PA

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