Look up the most recent NPI and PECOS records

Charles Marquis Peterson

Internal Medicine

Allopathic & Osteopathic Physicians

12910 Dalyn Dr, Potomac, MD 20854-1176

PECOS Enrollment

This provider is enrolled in PECOS as CHARLES PETERSON.

Based on the most recent information from CMS, provider Charles Marquis Peterson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1609026897
Provider Type
Individual
Full Name
Peterson, Charles Marquis
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
9/24/2008
Last Updated
6/22/2025

Contact Information

Practice Location

12910 Dalyn Dr, Potomac, MD 20854-1176

(301) 987-0847

Unlisted Fax

Mailing Location

1054 Patchell Street, Attn: Mcmr-Tt, Fort Detrick, MD 21702-5012

(301) 619-4197

(301) 619-2518

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License G 026308 California
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License L3589 Washington

Charles Marquis Peterson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Potomac On Call Llc

Zheng, Yanfang

Oussova, Tatiana

Patel, Rahul Y.

Tanenholz, Kelly J

Houn, Florence

Potomac Eldercare Physicians

Ahadpour, Mitra

Lee, Kok-Seah

Reiskin, Joel Alvin