Healthcare Provider Details

I. General information

NPI: 1588645816
Provider Name (Legal Business Name): ANOUK AMZEL MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 03/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4924 CAMPBELL BLVD STE 125
BALTIMORE MD
21236-5921
US

IV. Provider business mailing address

1201 PENNSYLVANIA AVENUE SUITE 200
WASHINGTON DC
20004
US

V. Phone/Fax

Practice location:
  • Phone: 443-461-1997
  • Fax:
Mailing address:
  • Phone: 703-473-7160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number205743
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0069319
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: