Individual provider · Type 1 NPI
Diana M. Ottulich, MD
Military Health Care Provider · Pearl Harbor, HI
NPI number
1629715552
Active
Practice location
822 Clark St
Pearl Harbor, HI 96860-4652
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician | 208D00000X | 0101280042 (VA) |
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Military Health Care Provider Primary | 171000000X | 0101280042 (VA) |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
4 other providers at this address
- Craig Randolph Soleim, NAVY IDCIndependent Duty Corpsman Pearl Harbor, HI NPI 1376589077
- David Terrance Repking, IDCOther Technician Pearl Harbor, HI NPI 1861454712
- Michael Glen Peck Jr., IDCIndependent Duty Corpsman Pearl Harbor, HI NPI 1407898539
- Michael James HaugheyIndependent Duty Corpsman Pearl Harbor, HI NPI 1205043726
About NPI 1629715552
Diana M. Ottulich, MD's National Provider Identifier is 1629715552, issued on May 12, 2022. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Pearl Harbor, HI. The record was last updated on May 28, 2024.