Provider Demographics
NPI:1992783260
Name:HARDING, PETER R (DO)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:R
Last Name:HARDING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 AVERY POINT WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7793
Practice Address - Country:US
Practice Address - Phone:804-542-4100
Practice Address - Fax:804-542-4101
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10819207R00000X
VA0102207534207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA204495282AMedicaid
FLP00815175OtherRR MEDICARE
FL0016066-00Medicaid
FL0016066-00Medicaid
FL0016066-00Medicaid
FLCQ985ZMedicare PIN