Healthcare Provider Details

I. General information

NPI: 1982889366
Provider Name (Legal Business Name): PETER LOWELL BEILENSON MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2008
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7178 COLUMBIA GATEWAY DR HOWARD COUNTY HEALTH DEPARTMENT
COLUMBIA MD
21046-2581
US

IV. Provider business mailing address

7178 COLUMBIA GATEWAY DR HOWARD COUNTY HEALTH DEPARTMENT
COLUMBIA MD
21046-2581
US

V. Phone/Fax

Practice location:
  • Phone: 410-313-6363
  • Fax: 410-313-6303
Mailing address:
  • Phone: 410-313-6363
  • Fax: 410-313-6303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD37352
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: