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General NPI Number Information
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NPI Number | 1912224700
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Entity Type | Individual
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Provider Name | ANQUENETTA LATOSHA DOUGLAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 1221 MERCANTILE LN
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City | LARGO
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State | MD
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Zip | 20774-5374
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Country | US
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Telephone | 301-618-5936
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Fax |
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Provider Business Mailing Address
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Address Line | 607 RIVER MIST DR
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City | OXON HILL
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State | MD
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Zip | 20745-3478
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Country | US
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Telephone | 330-272-4243
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | S4755
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | D72594
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License Number State | MD
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