Provider Demographics
NPI:1609953116
Name:DONMEZ, PETEK I (MD)
Entity type:Individual
Prefix:
First Name:PETEK
Middle Name:
Last Name:DONMEZ
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11613 TOULONE DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3146
Mailing Address - Country:US
Mailing Address - Phone:301-742-9328
Mailing Address - Fax:301-230-1897
Practice Address - Street 1:11125 ROCKVILLE PIKE STE 308
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3142
Practice Address - Country:US
Practice Address - Phone:301-230-1895
Practice Address - Fax:301-230-1897
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD017820900Medicaid