Provider Demographics
NPI:1225043045
Name:PEIRCE, HEATHER P (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:P
Last Name:PEIRCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2442
Mailing Address - Country:US
Mailing Address - Phone:301-724-4050
Mailing Address - Fax:301-724-4096
Practice Address - Street 1:220 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2442
Practice Address - Country:US
Practice Address - Phone:301-724-4050
Practice Address - Fax:301-724-4096
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033083204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD73826Medicare UPIN
MD6708Medicare ID - Type Unspecified