Healthcare Provider Details

I. General information

NPI: 1780683813
Provider Name (Legal Business Name): JOAN CANTERO-LAKHANPAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOAN CANTERO MD

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 FORBES ST SECOND FLOOR
ANNAPOLIS MD
21401-1502
US

IV. Provider business mailing address

PO BOX 64131
BALTIMORE MD
21264-4131
US

V. Phone/Fax

Practice location:
  • Phone: 410-571-7880
  • Fax: 410-571-0362
Mailing address:
  • Phone: 443-481-6480
  • Fax: 443-481-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD0053468
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: