# PENINSULA REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peninsula Gastroenterology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023240769
- **Authorized official:** DONNA E HORNER (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (410) 543-7531

## Contact information

- **Practice address:** 560 RIVERSIDE DR, SUITE A 206, SALISBURY, MD 21801-4700
- **Practice address phone:** (410) 912-5640
- **Practice address fax:** (410) 912-5641
- **Mailing address:** 100 E CARROLL ST, SALISBURY, MD 21801-5422
- **Mailing address phone:** (410) 543-7531
- **Mailing address fax:** (410) 912-6386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/13/2009
- **Last updated:** 08/13/2009