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NPI Code Detail

MEDICARE: ANNE ARUNDEL DERMATOLOGY, PA

MEDICARE: ANNE ARUNDEL DERMATOLOGY, PA
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
1207N00000XDermatology Physician

General Provider Information

NPI Number : 1326906025
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANNE ARUNDEL DERMATOLOGY, PA
Provider Business Mailing Address
First Line : PO BOX 23329
Second Line :
City : NEW YORK
State : NY
Zip : 10087-3329
Country : US
Telephone Number : 410-873-8500
Fax Number : 404-301-9057
Provider Business Practice Location Address
First Line : 180 ADMIRAL COCHRANE DR STE 420
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-8405
Country : US
Telephone Number : 410-263-5439
Fax Number : 410-263-7482
Authorized Official
Title or Position : ENROLLMENT SPECIALIST
Name : LAURA J HERNANDEZ
Credential :
Telephone Number : 813-493-5252
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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