MEDICARE: ANITA DAVID

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	363LF0000X	Family Nurse Practitioner	R178993	MD
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R178993	MD

General Provider Information

NPI Number	:	1730643610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA DAVID

Provider Business Mailing Address
First Line	:	1111 N CHARLES ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-5505
Country	:	US
Telephone Number	:	410-837-2050
Fax Number	:	866-629-0091

Provider Business Practice Location Address
First Line	:	6901 SECURITY BLVD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21244-2412
Country	:	US
Telephone Number	:	410-837-2050
Fax Number	:	866-629-0091

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

Provider Enumeration Date	:	01/25/2019
Last Update Date	:	09/11/2024

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Directions to “ ANITA DAVID ” Practice Location

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