Provider Demographics
NPI:1356985907
Name:PETER ALIU MD PLLC
Entity type:Organization
Organization Name:PETER ALIU MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIU
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:276-233-9982
Mailing Address - Street 1:103 STABLE WAY
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-8047
Mailing Address - Country:US
Mailing Address - Phone:276-233-9982
Mailing Address - Fax:859-687-0001
Practice Address - Street 1:103 STABLE WAY
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-8047
Practice Address - Country:US
Practice Address - Phone:276-233-9982
Practice Address - Fax:859-687-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYFA3448607OtherDEA