Healthcare Provider Details

I. General information

NPI: 1275513053
Provider Name (Legal Business Name): VALORIE ANLAGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17001 SCIENCE DRIVE SUITE 116
BOWIE MD
20715
US

IV. Provider business mailing address

9811 MALLARD DR SUITE 109
LAUREL MD
20708-3143
US

V. Phone/Fax

Practice location:
  • Phone: 301-464-2300
  • Fax: 301-776-8052
Mailing address:
  • Phone: 301-776-8000
  • Fax: 301-776-8052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD41154
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: