Individual
DR. SHAWN M PEFFALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7602 BELAIR RD, BALTIMORE, MD 21236-4088
(410) 663-8100
(410) 663-8119
Mailing address
PO BOX 62026, BALTIMORE, MD 21264-2026
(410) 659-1553
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0057104
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
970101005
—
MD
01
—
KF68/610285-01
BC/BS
MD
Enumeration date
04/27/2006
Last updated
06/25/2010
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