Individual
PETER KANISTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4983 DELHI AVE, SUITE 6, CINCINNATI, OH 45238-5380
(513) 347-7237
(513) 347-6567
Mailing address
1331 N ELM ST, SUITE 200, GREENSBORO, NC 27401-6302
(336) 274-9617
(336) 482-2177
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
35072703
OH
2085R0202X
Diagnostic Radiology Physician
Primary
35072707K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200938470
—
IN
05
—
2034622
—
OH
Enumeration date
07/05/2005
Last updated
03/07/2016
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