Provider Demographics
NPI:1184085656
Name:PETER Z ANDERS MD
Entity type:Organization
Organization Name:PETER Z ANDERS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:Z
Authorized Official - Last Name:ANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-225-0314
Mailing Address - Street 1:3447 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44127-1607
Mailing Address - Country:US
Mailing Address - Phone:216-225-0314
Mailing Address - Fax:
Practice Address - Street 1:5592 BROADVIEW RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-1677
Practice Address - Country:US
Practice Address - Phone:216-741-5200
Practice Address - Fax:216-741-5201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080748207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty