Provider Demographics
NPI:1447237342
Name:ENGEL, PETER (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ENGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 AUBURN AVE
Mailing Address - Street 2:STE 137
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-206-1180
Mailing Address - Fax:513-206-1183
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SUITE 137
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-206-1180
Practice Address - Fax:513-206-1183
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35035963207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00850046OtherRAILROAD MEDICARE
2520370OtherUNITED
OH311438871075OtherCARESOURCE MEDICAID
OH000000215169OtherANTHEM
0646624OtherAETNA
OH060033895OtherMEDICAL MUTUAL
OH283797OtherAMERIGROUP
INP00677036OtherRAILROAD MEDICARE
OH0381082Medicaid
35963-19OtherHUMANA
IN172680DMedicare PIN
A77826Medicare UPIN
OH000000215169OtherANTHEM
INP00677036OtherRAILROAD MEDICARE