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OTIS PRESTIGE NPI 1992431753


NPI Information

NPI: 1992431753
Provider Name: OTIS PRESTIGE
Classification: Internal Medicine - 207RI0200X
Entity Type: Organization

Specialization: Infectious Disease

Address:
109 ANDERSON ST SE STE 200A
MARIETTA, GA
ZIP 30060
Phone: (470) 301-8528
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OTIS PRESTIGE is an infectious disease internal medicine in Marietta, GA. The provider is an internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. OTIS PRESTIGE NPI is 1992431753. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

109 ANDERSON ST SE STE 200A
MARIETTA, GA
ZIP 30060-610
Phone: (470) 301-8528

The provider's authorized official is Damian Drago .
The authorized official title is Administrator and has the following contact phone number (470) 301-8528.

The enumeration date for this NPI number is 7/25/2022 and was last updated on 7/25/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2207RI0200XInternal MedicineInfectious DiseaseYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14703018528OTHERGEORGIA4703018528

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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