MEDICARE: PETER S PETROPOULOS MD

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	207P00000X	Emergency Medicine Physician	D0054822	MD

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
2	9901	OTHER		CAREFIRST

General Provider Information

NPI Number	:	1578551651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER S PETROPOULOS MD

Provider Business Mailing Address
First Line	:	1300 PICCARD DR
Second Line	:	STE 202
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-4303
Country	:	US
Telephone Number	:	301-921-7900
Fax Number	:	301-921-7915

Provider Business Practice Location Address
First Line	:	200 MEMORIAL AVE
Second Line	:	CARROLL HOSPITAL CENTER
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5726
Country	:	US
Telephone Number	:	410-871-6700
Fax Number	:	410-871-7177

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	07/08/2007

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