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General NPI Number Information
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NPI Number | 1164758702
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Entity Type | Organization
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Legal Business Name | PETER DITORO MD PC
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Dates
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Enumeration Date | 11/01/2009
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Last Update Date | 11/01/2009
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Provider Practice Location Address
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Address Line | 600 SAINT CLAIR AVE SW BLDG 5 SUITE 10
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5008
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Country | US
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Telephone | 256-536-7358
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Fax | 256-539-4083
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Provider Business Mailing Address
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Address Line | 600 SAINT CLAIR AVE SW BLDG 5 SUITE 10
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5008
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Country | US
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Telephone | 256-536-7358
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Fax | 256-539-4083
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. PETER DITORO
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Credential | MD
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Telephone | 256-536-7358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3910
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License Number State | AL
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