Healthcare Provider Details

I. General information

NPI: 1962715623
Provider Name (Legal Business Name): HEATHER P PEIRCE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 07/22/2010
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 Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD0033083
License Number StateMD

VIII. Authorized Official

Name: DR. HEATHER PAMELA PEIRCE
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 304-724-4050