Healthcare Provider Details

I. General information

NPI: 1992741011
Provider Name (Legal Business Name): ANJU PABBY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 L ST NW STE 850
WASHINGTON DC
20036-5111
US

IV. Provider business mailing address

1828 L ST NW STE 850
WASHINGTON DC
20036-5111
US

V. Phone/Fax

Practice location:
  • Phone: 202-822-9591
  • Fax: 202-775-1857
Mailing address:
  • Phone: 202-822-9591
  • Fax: 202-775-1857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD039981
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: