MEDICARE: DR. PETER L MOHRER M.D.

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	103TC0700X	Clinical Psychologist	028276	CT
2	2084P0800X	Psychiatry Physician	028276	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205800463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER L MOHRER M.D.

Provider Business Mailing Address
First Line	:	5 DURHAM RD
Second Line	:	SUITE B5
City	:	GUILFORD
State	:	CT
Zip	:	06437-2076
Country	:	US
Telephone Number	:	203-453-4870
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 DURHAM RD B5
Second Line	:
City	:	GUILFORD
State	:	CT
Zip	:	06437-2076
Country	:	US
Telephone Number	:	203-453-4870
Fax Number	:

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	10/27/2015

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