Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 4301405308-1036859 | MI |
NPI | 1407875313 |
---|---|
Provider Name | Dr. Martin Gerard Ottolini |
First Address | Gaithersburg, MD 20882-2025 |
Second Address | Bethesda, MD 20814-4712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 05/02/2013 |