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General NPI Number Information
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NPI Number | 1982605937
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Entity Type | Individual
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Provider Name | PETER M ROTHMAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 01/29/2010
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Provider Practice Location Address
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Address Line | 7920 W JEFFERSON BLVD SUITE 220
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City | FORT WAYNE
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State | IN
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Zip | 46804
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Country | US
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Telephone | 260-436-5670
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Fax | 260-436-4706
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Provider Business Mailing Address
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Address Line | 7920 W JEFFERSON BLVD SUITE 220
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City | FORT WAYNE
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State | IN
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Zip | 46804
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Country | US
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Telephone | 260-436-5670
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Fax | 260-436-4706
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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 | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 01026818A
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License Number State | IN
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