Provider Demographics
NPI:1659601664
Name:BIANCHINE, PETER J (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:BIANCHINE
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 1:6610 ROCKLEDGE DR
Mailing Address - Street 2:ROOM 6616
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1811
Mailing Address - Country:US
Mailing Address - Phone:301-435-4411
Mailing Address - Fax:301-402-2571
Practice Address - Street 1:6610 ROCKLEDGE DR
Practice Address - Street 2:ROOM 6616
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1811
Practice Address - Country:US
Practice Address - Phone:301-435-4411
Practice Address - Fax:301-402-2571
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0039914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine