Provider Demographics
NPI:1508382151
Name:PEART, MARSHA MELISSA (MD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:MELISSA
Last Name:PEART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 OSLER DR STE 305-307
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7736
Mailing Address - Country:US
Mailing Address - Phone:410-427-2020
Mailing Address - Fax:410-327-2013
Practice Address - Street 1:7505 OSLER DR STE 305-307
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7736
Practice Address - Country:US
Practice Address - Phone:410-427-2020
Practice Address - Fax:410-327-2013
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101270943207Q00000X
390200000X
MDD0090929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program