Provider Demographics
NPI:1093890550
Name:PELT, ALVIN D (MD)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:D
Last Name:PELT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:134 NORTHWOODS BLVD
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4727
Mailing Address - Country:US
Mailing Address - Phone:614-846-6611
Mailing Address - Fax:614-846-6662
Practice Address - Street 1:134 NORTHWOODS BLVD
Practice Address - Street 2:SUITE B-1
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4727
Practice Address - Country:US
Practice Address - Phone:614-846-6611
Practice Address - Fax:614-846-6662
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2023-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35 05 82452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0782032Medicaid
OH078 2032Medicaid
OHB48652Medicare UPIN