MEDICARE: PETER N. KATSAROS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35065423K	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144203910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER N. KATSAROS M.D.

Provider Business Mailing Address
First Line	:	3515 MASSILLON RD
Second Line	:	SUITE 300
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-6400
Country	:	US
Telephone Number	:	330-899-9350
Fax Number	:	330-634-1329

Provider Business Practice Location Address
First Line	:	3300 GREENWICH RD
Second Line	:	SUITE 8
City	:	NORTON
State	:	OH
Zip	:	44203-5714
Country	:	US
Telephone Number	:	330-825-7371
Fax Number	:	330-825-7473

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	06/23/2020

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