Organization
PENINSULA IMAGING L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER A. LIBBY M.D. (PRESIDENT)
(410) 749-1124
Entity
Organization
Contact information
Practice address
1655 WOODBROOKE DR, SUITE 101, SALISBURY, MD 21804-8502
(410) 749-1123
(410) 543-1065
Mailing address
918 EASTERN SHORE DR, SALISBURY, MD 21804-6410
(410) 749-1124
(410) 749-1270
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8005311
—
MD
01
—
KB55
CAREFIRST BLUE SHIELD
MD
Enumeration date
05/02/2006
Last updated
05/28/2009
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