Healthcare Provider Details

I. General information

NPI: 1386478956
Provider Name (Legal Business Name): ANNA QUINN SOLOMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

18900 LONGHOUSE PL
LEESBURG VA
20176-6464
US

V. Phone/Fax

Practice location:
  • Phone: 412-721-4359
  • Fax:
Mailing address:
  • Phone: 412-721-4359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: