| Doctor Name: | DR. WILLIAM SAMUEL OTTO |
| NPI Number: | 1043470958 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME31610 |
| Business Practice Address: | 2705 Amesbury Rd Winston Salem, NC - 271036752 |
| Business Phone Number: | 3367050392 |
| Business Fax Number: | 3367653401 |
| Mailing Address: | 2705 Amesbury Rd, WINSTON SALEM |
| State: | NC |
| Postal Code: | 271036752 |
| Phone Number: | 3367050392 |
| Fax Number: | 3367653401 |
| NPI Enumeration Date: | 06/13/2008 |
| NPI Last Update Date: | 06/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME31610 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |