Provider Demographics
NPI:1992099576
Name:MOTT-YOUNG, ADRIENNE HOPE (MD)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:HOPE
Last Name:MOTT-YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17853 STATE ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-8520
Mailing Address - Country:US
Mailing Address - Phone:937-578-4210
Mailing Address - Fax:937-578-4220
Practice Address - Street 1:17853 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-8520
Practice Address - Country:US
Practice Address - Phone:937-578-4210
Practice Address - Fax:937-578-4220
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.146938208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics