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NPI Code Detail

MEDICARE: DR. PETER MICHAEL DEVITO M.D.

MEDICARE:  DR. PETER MICHAEL DEVITO  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician35-64590OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679549620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER MICHAEL DEVITO M.D.
Provider Business Mailing Address
First Line : 7600 SOUTHERN BLVD
Second Line : SUITE 2
City : YOUNGSTOWN
State : OH
Zip : 44512-6085
Country : US
Telephone Number : 330-758-3985
Fax Number : 330-758-4264
Provider Business Practice Location Address
First Line : 7600 SOUTHERN BLVD
Second Line : SUITE 2
City : YOUNGSTOWN
State : OH
Zip : 44512-6085
Country : US
Telephone Number : 330-758-3985
Fax Number : 330-758-4264
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2006
Last Update Date : 09/25/2008

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