Healthcare Provider Details

I. General information

NPI: 1306884291
Provider Name (Legal Business Name): ANITA PHILIP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2695
US

IV. Provider business mailing address

820 BESTGATE RD STE 1A
ANNAPOLIS MD
21401-3404
US

V. Phone/Fax

Practice location:
  • Phone: 202-243-2280
  • Fax: 517-787-4146
Mailing address:
  • Phone: 410-224-2116
  • Fax: 410-224-2118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD034769
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: