Provider Demographics
NPI:1346531845
Name:SOTUS, PETER C (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:C
Last Name:SOTUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3766 TIMBERCREST CT
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-7108
Mailing Address - Country:US
Mailing Address - Phone:814-833-7690
Mailing Address - Fax:
Practice Address - Street 1:3766 TIMBERCREST CT
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-7108
Practice Address - Country:US
Practice Address - Phone:814-833-7690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 . 049687207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology