Healthcare Provider Details

I. General information

NPI: 1144203910
Provider Name (Legal Business Name): PETER N. KATSAROS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 06/23/2020
Certification Date: 06/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GREENWICH RD SUITE 8
NORTON OH
44203-5714
US

IV. Provider business mailing address

3515 MASSILLON RD SUITE 300
UNIONTOWN OH
44685-6400
US

V. Phone/Fax

Practice location:
  • Phone: 330-825-7371
  • Fax: 330-825-7473
Mailing address:
  • Phone: 330-899-9350
  • Fax: 330-634-1329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35065423K
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: