Individual
PETER C YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-1700
Mailing address
3605 WARRENSVILLE CENTER RD, SHAKER HEIGHTS, OH 44122-5203
(440) 684-5816
(440) 684-5952
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35-072144
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000203680
UNISON
OH
01
—
000000503578
ANTHEM
OH
01
—
0304914
BCMH
OH
05
—
1010340150001
—
PA
01
—
1609894880
MI MEDICAID
MI
05
—
2103477
—
OH
01
—
364159
WELLCARE
OH
01
—
5253604
AETNA
OH
01
—
732116
BUCKEYE
OH
01
—
P00358878
RAILROAD MEDICARE
OH
Enumeration date
07/17/2006
Last updated
04/07/2009
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