Healthcare Provider Details

I. General information

NPI: 1386671899
Provider Name (Legal Business Name): ANNAPOLIS MEDICAL SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 BESTGATE RD SUITE 300
ANNAPOLIS MD
21401-3089
US

IV. Provider business mailing address

900 BESTGATE RD SUITE 300
ANNAPOLIS MD
21401-3089
US

V. Phone/Fax

Practice location:
  • Phone: 410-573-5300
  • Fax: 410-266-9645
Mailing address:
  • Phone: 410-573-5300
  • Fax: 410-266-9645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEANINE L WERNER
Title or Position: PARTNER
Credential: M.D.
Phone: 410-573-5300