Provider Demographics
NPI:1316950066
Name:SHERER, PETER BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:BRUCE
Last Name:SHERER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 FERRARA DR
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20906-4709
Mailing Address - Country:US
Mailing Address - Phone:301-946-6420
Mailing Address - Fax:301-946-0642
Practice Address - Street 1:3921 FERRARA DR
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20906-4709
Practice Address - Country:US
Practice Address - Phone:301-946-6420
Practice Address - Fax:301-946-0642
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD21910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0549052OtherCIGNA
MD42089001OtherBCBS MD
MD775581300Medicaid
DC0001OtherBCBS DC
521230579OtherHEALTHLINK
0402086OtherUNITED HEALTHCARE
4053731OtherAETNA
922531OtherHEALTHKEEPERS
4053731OtherAETNA
MD42089001OtherBCBS MD