Healthcare Provider Details

I. General information

NPI: 1821314030
Provider Name (Legal Business Name): VALSAMO ANAGNOSTOU MD-PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 10/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 ORLEANS STREET CRB 186
BALTIMORE MD
21231
US

IV. Provider business mailing address

915 S WOLFE STREET APT 538
BALTIMORE MD
21231
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-8893
  • Fax: 410-955-8587
Mailing address:
  • Phone: 203-444-3456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberD76717
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: