Otsuka, Mayumi

Otsuka, Mayumi is an individual health care provider with primary practice located at 516 East Nizhoni Blvd , Gallup NM 87301-1337. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Otsuka, Mayumi can be contacted via phone (505) 722-1000.

Contact Information

Primary practice address
516 East Nizhoni Blvd Gallup NM 87301-1337
Phone: (505) 722-1000
Fax: (505) 722-1268
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0420010593 Vermont

Profile Details

NPI number 1518954999
LBN Legal business name Otsuka, Mayumi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Apr 29th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518954999 NPPES
Colorado MEDICAID 24559342
Colorado MEDICAID 811457
Colorado MEDICAID 63139324

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