Provider Demographics
NPI:1245214964
Name:FILDERMAN, PETER S (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:S
Last Name:FILDERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5421
Mailing Address - Country:US
Mailing Address - Phone:410-644-0929
Mailing Address - Fax:410-644-4338
Practice Address - Street 1:3407 WILKENS AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5072
Practice Address - Country:US
Practice Address - Phone:410-644-0929
Practice Address - Fax:410-644-4338
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0038640208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD594061300Medicaid
F62685Medicare UPIN
MD731LO197Medicare PIN