Provider Demographics
NPI:1629082581
Name:STATUTO, DONALD THOMAS (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:THOMAS
Last Name:STATUTO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 SAND HILL RD
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1616
Mailing Address - Country:US
Mailing Address - Phone:603-557-2608
Mailing Address - Fax:603-924-4094
Practice Address - Street 1:429 SAND HILL RD
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1616
Practice Address - Country:US
Practice Address - Phone:603-557-2608
Practice Address - Fax:603-924-4094
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH67482083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine