Provider Demographics
NPI:1598939704
Name:OTTOLINI, SCOTT ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ROBERT
Last Name:OTTOLINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11404 MACPHERSON CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2062
Mailing Address - Country:US
Mailing Address - Phone:313-993-2530
Mailing Address - Fax:313-993-7703
Practice Address - Street 1:11404 MACPHERSON CT
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-2062
Practice Address - Country:US
Practice Address - Phone:313-993-2530
Practice Address - Fax:313-993-7703
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301087975207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine