Healthcare Provider Details

I. General information

NPI: 1235163254
Provider Name (Legal Business Name): PETER KREMERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 7TH ST
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

PO BOX 1966
FREDERICK MD
21702-0966
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3300
  • Fax:
Mailing address:
  • Phone: 301-663-1277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD35063
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: