Provider Demographics
NPI:1780667139
Name:VAUTHY, PIERRE A (MD)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:A
Last Name:VAUTHY
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 1:2121 HUGHES DR
Mailing Address - Street 2:HMT SUITE 640
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3845
Mailing Address - Country:US
Mailing Address - Phone:419-291-2207
Mailing Address - Fax:419-479-6998
Practice Address - Street 1:2121 HUGHES DR
Practice Address - Street 2:HMT SUITE 640
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3845
Practice Address - Country:US
Practice Address - Phone:419-291-2207
Practice Address - Fax:419-479-6998
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037406V2080P0214X
OH350347062080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4207285OtherAETNA
MI5202279Medicaid
108738OtherGLHP
6146OtherHEALTH PLAN OF MI
OH00280OtherPARAMOUNT
OH000000520831OtherANTHEM
000000219652OtherUNISON
OH0311844Medicaid
000000219652OtherUNISON
MI5202279Medicaid
OH0311844Medicaid
000000219652OtherUNISON
OHA76410Medicare UPIN