Individual
PETER OTTAVIANO
Active
Individual
PETER OTTAVIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
1144
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0042458000
—
WV
05
—
0917128
—
OH
01
—
290005124
RAILROAD MEDICARE
—
05
—
6407504
—
KY
Enumeration date
07/07/2006
Last updated
11/06/2012
Update your record
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