Provider Demographics
NPI:1285701052
Name:STANOS, PETER STEVEN (DO)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:STEVEN
Last Name:STANOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 S STANWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BEXLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1859
Mailing Address - Country:US
Mailing Address - Phone:614-236-0271
Mailing Address - Fax:
Practice Address - Street 1:184 S STANWOOD RD
Practice Address - Street 2:
Practice Address - City:BEXLEY
Practice Address - State:OH
Practice Address - Zip Code:43209-1859
Practice Address - Country:US
Practice Address - Phone:614-236-0271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006030208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2201441Medicaid
OH9308861Medicare ID - Type Unspecified
OH2201441Medicaid