Basic Information
| Provider Information | |||||||||
| NPI: | 1700113032 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MARK OB PEELER MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 64323 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212644323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434816549 | ||||||||
| FaxNumber: | 4434816515 | ||||||||
| Practice Location | |||||||||
| Address1: | 1630 MAIN ST | ||||||||
| Address2: | SUITE 213 | ||||||||
| City: | CHESTER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216192791 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102661188 | ||||||||
| FaxNumber: | 4102669466 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2009 | ||||||||
| LastUpdateDate: | 02/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | PEELER | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4434816464 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.