Healthcare Provider Details

I. General information

NPI: 1104453471
Provider Name (Legal Business Name): GI-ANN ABDON ACOSTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 ALLENTOWN RD STE 502
CAMP SPRINGS MD
20746-4653
US

IV. Provider business mailing address

5801 ALLENTOWN RD STE 502
CAMP SPRINGS MD
20746-4653
US

V. Phone/Fax

Practice location:
  • Phone: 240-427-1630
  • Fax: 240-439-8285
Mailing address:
  • Phone: 240-427-1630
  • Fax: 240-439-8285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberD0107561
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: