Provider Demographics
NPI:1851349260
Name:SOTOS, PETER N (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:N
Last Name:SOTOS
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 1:600 MEDICAL ARTS BLDG
Mailing Address - Street 2:SUSITE # 660
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-7134
Mailing Address - Country:US
Mailing Address - Phone:724-543-9087
Mailing Address - Fax:724-543-9115
Practice Address - Street 1:600 MEDICAL ARTS BLDG
Practice Address - Street 2:SUSITE # 660
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7134
Practice Address - Country:US
Practice Address - Phone:724-543-9087
Practice Address - Fax:724-543-9115
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037341-L207X00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008653210003Medicaid
B37917Medicare UPIN
PA133133Medicare ID - Type Unspecified