MEDICARE: DR. ANNE ZAJICEK M.D., PHARM.D.

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	208000000X	Pediatrics Physician	A72792	CA

General Provider Information

NPI Number	:	1588724348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE ZAJICEK M.D., PHARM.D.

Provider Business Mailing Address
First Line	:	6100 EXECUTIVE BLVD
Second Line	:	SUITE 4A01 MSC 7510
City	:	BETHESDA
State	:	MD
Zip	:	20892-7510
Country	:	US
Telephone Number	:	301-435-6865
Fax Number	:	301-480-2897

Provider Business Practice Location Address
First Line	:	6100 EXECUTIVE BLVD
Second Line	:	SUITE 4A01 MSC 7510
City	:	BETHESDA
State	:	MD
Zip	:	20892-0001
Country	:	US
Telephone Number	:	301-435-6865
Fax Number	:	301-480-2897

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	03/13/2008

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