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Individual

DR. PETER L WISNIEWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
985 PRINCE FREDERICK BLVD STE 201, PRINCE FREDERICK, MD 20678-3492
(410) 535-2005
(410) 535-4850
Mailing address
985 PRINCE FREDERICK BLVD STE 201, PRINCE FREDERICK, MD 20678-3492
(410) 535-2005
(410) 535-4850

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D40370
MD
207RP1001X
Pulmonary Disease Physician
D40370
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110108206
RAILROAD MEDICARE
MD
01
2148224
AETNA HMO PCP
MD
01
2154481
AETNA HMO SPECIALIST
MD
01
436794
MAMSI HMO SPECIALIST
MD
01
4461101
AETNA NON-HMO PCP
MD
01
52585801
CAREFIRST OF MARYLAND
MD
05
762771800
MD
01
7720001
AETNA NON-HMO SPECIALIST
MD
01
836794
MAMSI HMO PCP
MD
01
C0410016
CAREFIRST OF DC
DC
Enumeration date
01/10/2007
Last updated
02/21/2019
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