Individual
PETER PITONAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
00024770
AL
207RC0000X
Cardiovascular Disease Physician
Primary
M9934
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051511035
—
AL
01
—
110248812
RAILROAD MEDICARE
AL
01
—
51511035
BLUE CROSS BLUE SHIELD
AL
01
—
75-2616977-132
TRICARE
TX
Enumeration date
10/13/2006
Last updated
04/18/2023
Update your record
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