MEDICARE: ANCHOR DERMATOLOGY

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
1	207ND0900X	Dermatopathology Physician
2	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1588538607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCHOR DERMATOLOGY

Provider Business Mailing Address
First Line	:	43 SOUTHGATE AVE
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-2828
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 NORTHVIEW DR STE 200
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2640
Country	:	US
Telephone Number	:	443-637-2888
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. CHERYL LONERGAN
Credential	:	MD
Telephone Number	:	704-968-7189

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	10/01/2025

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Directions to “ANCHOR DERMATOLOGY ” Practice Location

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