Provider Demographics
NPI:1770810491
Name:PETEK DONMEZ, MD, P.C.
Entity type:Organization
Organization Name:PETEK DONMEZ, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETEK
Authorized Official - Middle Name:
Authorized Official - Last Name:DONMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-742-9328
Mailing Address - Street 1:11613 TOULONE DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3146
Mailing Address - Country:US
Mailing Address - Phone:301-742-9328
Mailing Address - Fax:
Practice Address - Street 1:11125 ROCKVILLE PIKE STE 308
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3142
Practice Address - Country:US
Practice Address - Phone:301-230-1895
Practice Address - Fax:301-230-1897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD017820900Medicaid