Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 35.135869 | OH |
NPI | 1093193591 |
---|---|
Provider Name | Dr. Peter Surace |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2015 |
Last Update Date | 02/08/2021 |