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Individual

DR. PETER L SCUDERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3700 JOSEPH SIEWICK DR, SUITE 308, FAIRFAX, VA 22033-1744
(703) 698-8960
(647) 646-4744
Mailing address
3700 JOSEPH SIEWICK DR, SUITE 308, FAIRFAX, VA 22033-1744
(703) 698-8960
(703) 716-8703

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101047453
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100013570
RAILROAD MEDICARE
VA
01
178708
ANTHEM BCBS
01
187600
ANTHEM BCBS
01
334231
ANTHEM BCBS
01
334232
ANTHEM BCBS
01
341905
ANTHEM BCBS
01
452928
ANTHEM BCBS
05
6031102
VA
01
79160011
CAREFIRST BCBS
Enumeration date
02/24/2006
Last updated
05/07/2019
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