Provider Demographics
NPI:1437306669
Name:PELT CONSULTATION AND BEHAVIORAL MEDICINE
Entity Type:Organization
Organization Name:PELT CONSULTATION AND BEHAVIORAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PELT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-846-6611
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-8245-P2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty