Individual
DONALD PESAVENTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9301 CONNECTICUT DRIVE, CROWN POINT, IN 46307-7486
(219) 796-4117
Mailing address
9301 CONNECTICUT DRIVE, CROWN POINT, IN 46307-7486
(219) 756-2100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01032265A
IN
208600000X
Surgery Physician
01032265A
IN
Other
Enumeration date
07/17/2006
Last updated
07/19/2011
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