Provider Demographics
NPI:1609011097
Name:OTUBU, ORITSETSEMAYE (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:ORITSETSEMAYE
Middle Name:
Last Name:OTUBU
Suffix:
Gender:F
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 GEORGIA NW AVE 2ND
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3027
Mailing Address - Country:US
Mailing Address - Phone:202-865-6679
Mailing Address - Fax:202-865-1617
Practice Address - Street 1:2139 GEORGIA AVE NW FL 4
Practice Address - Street 2:HOWARD UNIVERSITY FAMILY HEALTH CENTER
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3006
Practice Address - Country:US
Practice Address - Phone:202-865-7499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038700207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program