Individual
PETER ALEXANDER DEGOLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVENUE, CLEVELAND, OH 44106
(216) 844-3944
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FLOOR, SHAKER HEIGHTS, OH 44122
(216) 286-6295
(216) 286-6341
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
35062016
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221407
UNISON
OH
01
—
000000531122
ANTHEM
OH
05
—
0968243
—
OH
01
—
414960
WELLCARE
OH
01
—
4558739
AETNA
OH
01
—
738457
BUCKEYE
OH
01
—
P00412320
RAILROAD MEDICARE
OH
Enumeration date
07/07/2006
Last updated
03/06/2008
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