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General NPI Number Information
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NPI Number | 1457173197
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Entity Type | Organization
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Legal Business Name | ANNE ARUNDEL GASTROENTEROLOGY ASSOCIATES PA
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 8109 RITCHIE HWY STE 102
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City | PASADENA
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State | MD
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Zip | 21122-6903
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Country | US
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Telephone | 410-224-2116
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Fax |
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Provider Business Mailing Address
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Address Line | 820 BESTGATE RD STE 2B
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OFFICER
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Name | PRAVEENA GANNI VELAMATI
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Credential |
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Telephone | 410-224-2116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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