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Individual

PETER M ROTHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7920 W JEFFERSON BLVD, SUITE 220, FORT WAYNE, IN 46804
(260) 436-5670
(260) 436-4706
Mailing address
7920 W JEFFERSON BLVD, SUITE 220, FORT WAYNE, IN 46804
(260) 436-5670
(260) 436-4706

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
01026818A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100050320A
IN
Enumeration date
08/02/2005
Last updated
01/29/2010
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