Provider Demographics
NPI:1215392105
Name:BOTTI, ANNE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:BOTTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4497 KIPLING RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-4207
Mailing Address - Country:US
Mailing Address - Phone:614-457-6227
Mailing Address - Fax:
Practice Address - Street 1:4497 KIPLING RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-4207
Practice Address - Country:US
Practice Address - Phone:614-457-6227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-083953207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine