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General NPI Number Information
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NPI Number | 1881424562
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Entity Type | Organization
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Legal Business Name | ANNE ARUNDEL DERMATOLOGY, P.A.
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Dates
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Enumeration Date | 08/06/2024
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 2730 UNIVERSITY BLVD W STE 400
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City | SILVER SPRING
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State | MD
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Zip | 20902-1972
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Country | US
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Telephone | 301-933-1547
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Fax | 301-933-1547
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Provider Business Mailing Address
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Address Line | 1306 CONCOURSE DR STE 201
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City | LINTHICUM HEIGHTS
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State | MD
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Zip | 21090-1033
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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 | MD
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Name | ANGELA RUTH PETERMAN
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Credential |
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Telephone | 443-351-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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