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General NPI Number Information
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NPI Number | 1326069238
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Entity Type | Organization
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Legal Business Name | ANSON J JOSEPH - PATUXENT NEPHROLOGY ASSOC LLC
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 205 STEEPLE CHASE DR SUITE #206
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4053
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Country | US
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Telephone | 410-535-2085
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Fax | 410-535-0404
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Provider Business Mailing Address
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Address Line | PO BOX 2424
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-2424
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Country | US
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Telephone | 410-535-2985
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Fax | 410-535-0404
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Authorized Official
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Title or Position | MD
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Name | DR. ANSON JACOB JOSEPH
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Credential | MD
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Telephone | 410-535-2085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | D56161
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License Number State | MD
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