Provider Demographics
NPI:1710144720
Name:PEICHERT, KRISTEN MILLER (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MILLER
Last Name:PEICHERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:LEIGH
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3100 WYMAN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7671 QUARTERFIELD RD
Practice Address - Street 2:SUITE 401
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4998
Practice Address - Country:US
Practice Address - Phone:443-270-6760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0073057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine