MEDICARE: MATTHEW NEIL PETERS I MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	D78995	MD

General Provider Information

NPI Number	:	1588956304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW NEIL PETERS I MD

Provider Business Mailing Address
First Line	:	515 FAIRMOUNT AVE STE 400
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-8518
Country	:	US
Telephone Number	:	410-296-5300
Fax Number	:	410-494-1302

Provider Business Practice Location Address
First Line	:	120 WESTMINSTER PIKE STE 106
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-1027
Country	:	US
Telephone Number	:	410-494-1397
Fax Number	:	410-584-2257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2011
Last Update Date	:	10/21/2025

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