Provider Demographics
NPI:1699845388
Name:ZAFIRIDES, PETER PANOS (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:PANOS
Last Name:ZAFIRIDES
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 1:1842 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212
Mailing Address - Country:US
Mailing Address - Phone:614-488-1991
Mailing Address - Fax:
Practice Address - Street 1:5151 REED RD
Practice Address - Street 2:BLDG C-128 CENTRAL OHIO BEHAVIORAL MEDICINE INC
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220
Practice Address - Country:US
Practice Address - Phone:614-538-8300
Practice Address - Fax:614-538-1656
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350674562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2059954Medicaid
OH2059954Medicaid
G07827Medicare UPIN