Provider Demographics
NPI:1336258383
Name:PETER M. SCHISSLER MD P.A.
Entity Type:Organization
Organization Name:PETER M. SCHISSLER MD P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:SCHISSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-345-5857
Mailing Address - Street 1:7500 GREENWAY CENTER DR
Mailing Address - Street 2:STE 430
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3502
Mailing Address - Country:US
Mailing Address - Phone:301-345-5857
Mailing Address - Fax:301-474-5621
Practice Address - Street 1:7500 GREENWAY CENTER DR
Practice Address - Street 2:STE 430
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3502
Practice Address - Country:US
Practice Address - Phone:301-345-5857
Practice Address - Fax:301-474-5621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0265590001Medicare NSC