Healthcare Provider Details

I. General information

NPI: 1225043045
Provider Name (Legal Business Name): HEATHER P PEIRCE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 BALTIMORE AVE
CUMBERLAND MD
21502-2442
US

IV. Provider business mailing address

220 BALTIMORE AVE
CUMBERLAND MD
21502-2442
US

V. Phone/Fax

Practice location:
  • Phone: 301-724-4050
  • Fax: 301-724-4096
Mailing address:
  • Phone: 301-724-4050
  • Fax: 301-724-4096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberD0033083
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: