Otellin, Alexander Vladimirovich
Otellin, Alexander Vladimirovich is an sole proprietor health care provider with primary practice located at 401 Division St Ste 307 , South Charleston WV 25309-1455. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Otellin, Alexander Vladimirovich can be contacted via phone (304) 932-4259.Contact Information
Primary practice address
401 Division St Ste 307
South Charleston WV 25309-1455
Phone: (304) 932-4259
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 22592 | West Virginia |
Profile Details
| NPI number | 1740302066 |
|---|---|
| LBN Legal business name | Otellin, Alexander Vladimirovich |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 6th, 2007 |
| Last updated | Sep 17th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740302066 | NPPES |
| West Virginia | MEDICAID | 3810009290 |
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