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NPI Code Detail

MEDICARE: DR. TODD J PESEK M.D.

MEDICARE: DR. TODD J PESEK 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
1208D00000XGeneral Practice Physician35.091001OH

General Provider Information

NPI Number : 1669627816
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD J PESEK M.D.
Provider Business Mailing Address
First Line : 5555 MAYFIELD RD
Second Line :
City : LYNDHURST
State : OH
Zip : 44124-2939
Country : US
Telephone Number : 440-995-0555
Fax Number :
Provider Business Practice Location Address
First Line : 5555 MAYFIELD RD
Second Line :
City : LYNDHURST
State : OH
Zip : 44124-2939
Country : US
Telephone Number : 440-995-0555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2008
Last Update Date : 06/30/2010

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Directions to “ DR. TODD J PESEK M.D.” Practice Location

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