Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 01065693A | IN |
NPI | 1023157278 |
---|---|
Provider Name | Mr. Peter K Tothy |
First Address | Crown Point, IN 46307-8693 |
Second Address | Crown Point, IN 46307-8693 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 22/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200911390 | (05) | IN |
I36617 | (02) | IL |