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Individual

MOLLY ROSE PETERSCHMIDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3357B CORRIDOR MARKETPLACE, LAUREL, MD 20724-2381
(301) 497-1820
Mailing address
11640 NW STONE MOUNTAIN LN APT 206, PORTLAND, OR 97229-5993

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0009546
MD
363AM0700X
Medical Physician Assistant
PA217870
OR

Other

Enumeration date
09/19/2023
Last updated
10/15/2024
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