Provider Demographics
NPI:1144203910
Name:KATSAROS, PETER N (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:N
Last Name:KATSAROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3515 MASSILLON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-6400
Mailing Address - Country:US
Mailing Address - Phone:330-899-9350
Mailing Address - Fax:330-634-1329
Practice Address - Street 1:3300 GREENWICH RD
Practice Address - Street 2:SUITE 8
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-5714
Practice Address - Country:US
Practice Address - Phone:330-825-7371
Practice Address - Fax:330-825-7473
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2020-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35065423K207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0949433Medicaid
OH0949433Medicaid
OHF68926Medicare UPIN