Provider Demographics
NPI:1407196199
Name:SEARS, PETER D (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:D
Last Name:SEARS
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 1:809 FREEDOM PLAZA CIR
Mailing Address - Street 2:APT 307
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-5288
Mailing Address - Country:US
Mailing Address - Phone:813-642-9431
Mailing Address - Fax:
Practice Address - Street 1:809 FREEDOM PLAZA CIR
Practice Address - Street 2:APT 307
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5288
Practice Address - Country:US
Practice Address - Phone:813-642-9431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075011208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice