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General NPI Number Information
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NPI Number | 1174132724
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Entity Type | Individual
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Provider Name | PETR PIKHUT MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4319
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Country | US
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Telephone | 800-879-2467
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Fax |
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Provider Business Mailing Address
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Address Line | 512 N HOLLY ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-1769
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Country | US
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Telephone | 347-737-8069
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 20240113880
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | MT230223
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License Number State | PA
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