Peter E Baziotis, MD

Individual provider Active NPI Anesthesiology Physician · Pawtucket, RI

NPI 1376536664 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376536664
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
MD08592 (RI)
Practice address
111 Brewster St
Anesthesia Department
Pawtucket, RI 02860-4400
Phone
(401) 726-7300
Fax
(401) 726-7330
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD08592RIMDAnesthesiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD08592 RI Yes

Addresses

Primary practice location

111 Brewster St
Anesthesia Department
Pawtucket, RI 02860-4400

Mailing address

200 Main St
Suite 350
Pawtucket, RI 02860-4119
Phone (401) 726-7300

Other identifiers

IdentifierTypeStateIssuer
402881OtherRIBLUECHIP
2378OtherRINEIGHBORHOOD HEALTH
3201511OtherRIMASSACHUSETTS MEDICAID
7004143MedicaidRI
2822OtherRIPILGRAM HEALTHCARE
8592OtherRITUFTS HEALTH PLAN

Other providers in Pawtucket, RI

All providers in Pawtucket, RI · Anesthesiology Physician in Rhode Island

Sources for this page

Verify at the official NPI Registry.