Individual
PETER M DZIAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
95 S PAGOSA BLVD, PAGOSA SPRINGS, CO 81147-8329
(970) 731-3700
(970) 731-0504
Mailing address
95 S PAGOSA BLVD, PAGOSA SPRINGS, CO 81147-8329
(970) 731-3700
(970) 731-0504
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35051892D
OH
208600000X
Surgery Physician
Primary
DR.0051648
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000500815
ANTHEM
—
01
—
00160
PARAMOUNT
OH
05
—
0665696
—
OH
01
—
20-82460
UHC
—
01
—
297443892-005
MMO
—
01
—
4044721
AETNA
—
05
—
5189177
—
MI
01
—
P00389820
RRMC
OH
Enumeration date
05/31/2005
Last updated
09/24/2015
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