Provider Demographics
NPI:1740271493
Name:OTCHY, DANIEL P (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:OTCHY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2710 PROPERSITY AVENUE
Mailing Address - Street 2:200
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031
Mailing Address - Country:US
Mailing Address - Phone:703-280-2841
Mailing Address - Fax:703-280-4773
Practice Address - Street 1:2710 PROPERSITY AVENUE
Practice Address - Street 2:200
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:703-280-2841
Practice Address - Fax:703-280-4773
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2018-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101230552208C00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5860547Medicaid
VAF44781Medicare UPIN