Healthcare Provider Details

I. General information

NPI: 1467482505
Provider Name (Legal Business Name): RUTHANNE QUEENAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 HARRY S TRUMAN PKWY STE 120
ANNAPOLIS MD
21401-7580
US

IV. Provider business mailing address

2000 MEDICAL PKWY STE 409
ANNAPOLIS MD
21401-3746
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-4442
  • Fax: 410-224-8898
Mailing address:
  • Phone: 667-204-7212
  • Fax: 443-481-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number172905
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: