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NPI Code Detail

MEDICARE: DR. ANDREA KARIN PROSSER MD

MEDICARE: DR. ANDREA KARIN PROSSER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianD0059149MD

General Provider Information

NPI Number : 1275606568
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA KARIN PROSSER MD
Provider Business Mailing Address
First Line : 2101 EAST JEFFERSON STREET
Second Line : KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
City : ROCKVILLE
State : MD
Zip : 20852-4908
Country : US
Telephone Number : 301-816-6660
Fax Number : 301-816-6308
Provider Business Practice Location Address
First Line : 6104 OLD BRANCH AVENUE
Second Line :
City : TEMPLE HILLS
State : MD
Zip : 20748-2518
Country : US
Telephone Number : 301-702-6100
Fax Number : 301-702-6366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 05/31/2021

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