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General NPI Number Information
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NPI Number | 1790939973
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Entity Type | Individual
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Provider Name | PETER DOWIATT DO
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Gender | Male
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 07/05/2012
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Provider Practice Location Address
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Address Line | 332 CONGRESS PARK DR PREMIER PHYSICIAN SERVICES
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City | DAYTON
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State | OH
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Zip | 45459-4133
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Country | US
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Telephone | 180-072-6362
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Fax |
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Provider Business Mailing Address
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Address Line | 4750 HEMPSTEAD STATION DR
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City | KETTERING
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State | OH
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Zip | 45429-5164
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Country | US
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Telephone | 800-875-0136
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4299
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 910
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34.010548
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License Number State | OH
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