IndividualActive
Autumn Otto, PA-C
NPI 1558189282 · Surgical Physician Assistant · Bangor, ME
Provider details
- NPI number
- 1558189282
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
- Medical Physician Assistant363AM0700X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
489 State St
Bangor, ME 04401-6616
Phone: (207) 973-7000
Approximate (ZIP-level) locationGet directions
Mailing address
7741 Wertzville Rd
Carlisle, PA 17013-9021
Registry dates
- Enumerated
- 2024-10-01
- Last updated
- 2024-10-01
- Certified
- 2024-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.