Provider Demographics
NPI:1902867401
Name:SLOANE, PETER J (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:SLOANE
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 1:1768 BUSINESS CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5359
Mailing Address - Country:US
Mailing Address - Phone:800-762-9244
Mailing Address - Fax:786-672-6006
Practice Address - Street 1:515 FAIRMOUNT AVE STE 500
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5466
Practice Address - Country:US
Practice Address - Phone:410-832-3400
Practice Address - Fax:410-494-1718
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD41593207R00000X, 207RP1001X
MDD0041593207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD083961200Medicaid
0012OtherBC/BS
MD52320504OtherBC/BS
263061OtherRAILROAD MEDICARE
MD52320504OtherBC/BS
F03620Medicare UPIN