Provider Demographics
NPI:1467558452
Name:EROSSY, PETER J (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:EROSSY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:24651 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5635
Mailing Address - Country:US
Mailing Address - Phone:440-895-5056
Mailing Address - Fax:440-333-2935
Practice Address - Street 1:26016 DETROIT RD
Practice Address - Street 2:SUITE 7
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2477
Practice Address - Country:US
Practice Address - Phone:440-614-0626
Practice Address - Fax:440-614-0625
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2016-04-27
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Provider Licenses
StateLicense IDTaxonomies
OH51325207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0756883Medicaid
OH0756883Medicaid
0585053Medicare PIN