Individual
DR. PETER PAUL BERTOLOZZI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
49914
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5101017291
EDUCATION LISCENCE
MI
01
—
5315031607
CONTROLLED SUBSTANCE LIS
MI
Enumeration date
01/27/2008
Last updated
03/07/2019
Update your record
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