ANNE ARUNDEL PHYSICIAN GROUP LLC (NPI# 1588682389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588682389 |
| Entity Type | Organization |
| Organization Name | ANNE ARUNDEL PHYSICIAN GROUP LLC |
| Other Organization Name | ANNAPOLIS CENTER FOR INTEGRATIVE MEDICINE |
| Practice Address |
2009 Tidewater Colony Suite 2a Annapolis MD 21401 |
| Mailing Address |
Po Box 12622 Belfast ME 04915-4017 |
| Practice Telephone | 4102240010 |
| Practice Fax Number | 4102240012 |
| Mailing Telephone | 4434816483 |
| Mailing Fax Number | 4434816515 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-11-29 |
| Authorized Official Name | MR. STEPHEN CLARKE (VICE PRESIDENT) |
| Authorized Official Telephone | 4434811000 |
| Is Organization Subpart | Y |
| Parent Organization Name | ANNE ARUNDEL PHYSICIAN GROUP LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | D0018529 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 407175109 | 05 | |
| DC | BCBS | K640 | 01 |
| MD | BCBS | 953BAN | 01 |
| Other Name | Type Code |
|---|---|
| ANNAPOLIS CENTER FOR INTEGRATIVE MEDICINE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093342438 | Anne Arundel Physician Group LLC | Internal Medicine | 2003 Medical Pkwy Ste 350, Annapolis, MD 21401-3081 | 2020-03-25 |
| 1558732776 | Anne Arundel Physician Group LLC | Psychiatric Unit | 175 Harry S Truman Pkwy, Annapolis, MD 21401-7573 | 2015-10-14 |
| 1548595978 | Anne Arundel Physician Group LLC | Internal Medicine | 1106 Annapolis Rd Ste 210, Odenton, MD 21113-1740 | 2009-10-02 |
| 1831640465 | Anne Arundel Physician Group LLC | Dietitian, Registered | 1450 Mercantile Ln, Suite 111, Largo, MD 20774-5376 | 2016-10-19 |
| 1811353733 | Anne Arundel Physician Group LLC | Advanced Practice Midwife | 401 Purdy St, Suite 102, Easton, MD 21601-4060 | 2016-01-07 |
| 1407227598 | Anne Arundel Physician Group LLC | Advanced Practice Midwife | 401 Purdy St, Suite 102, Easton, MD 21601-4060 | 2015-10-14 |
| 1851710552 | Anne Arundel Physician Group LLC | Surgery | 4175 N Hanson Ct, Suite 201, Bowie, MD 20716-3179 | 2014-04-09 |
| 1063837490 | Anne Arundel Physician Group LLC | Family Medicine | 8109 Ritchie Hwy, Suite 100, Pasadena, MD 21122-6917 | 2014-02-21 |
| 1871920702 | Anne Arundel Physician Group LLC | Family Medicine | 555 Cynwood Dr, Easton, MD 21601-3801 | 2013-10-10 |
| 1891130209 | Anne Arundel Physician Group LLC | Internal Medicine | 888 Bestgate Rd, Suite 208, Annapolis, MD 21401-3091 | 2013-04-30 |
| Street Address |
2009 TIDEWATER COLONY SUITE 2A |
| City | ANNAPOLIS |
| State | MD |
| Zip Code | 21401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377154 | Michael Khorsandi | Student in an Organized Health Care Education/Training Program | 2001 Medical Parkway, Clatanoff Pavillon, Gmw Office, Annapolis, MD 21401 | 2020-05-15 |
| 1275172033 | Katrice N Nelson | Massage Therapist | Wellsview Cottage Center, 613 Ridgely Avenue, Annapolis, MD 21401 | 2019-12-27 |
| 1548803521 | Victoria Reimnitz | Behavioral Analyst | 2028 Indusrtrial Dr, Ste B&c, Annapolis, MD 21401 | 2019-10-23 |
| 1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
| 1316504848 | Sherina Maryam Shamsa | Counselor | 1830 Forest Drive, Suite H-2, Annapolis, MD 21401 | 2019-05-21 |
| 1497225288 | Jerilyn Deitch | Speech-Language Pathologist | Anne Arundel County Public Schools, 2644 Riva Rd, Annapolis, MD 21401 | 2018-12-05 |
| 1487124038 | Lucinda W Mimms | Speech-Language Pathologist | 2644 Riva Rd., Annapolis, MD 21401 | 2018-11-27 |
| 1487145496 | Michelle Baudean | Behavior Technician | 1919 West St Ste 201, Annapolis, MD 21401 | 2018-05-24 |
| 1730678954 | Stephanie Ruth Streb | Registered Nurse | 130 Admiral Cochrane Dr Ste 103, Annapolis, MD 21401 | 2018-05-02 |
| 1780183947 | Annapolis Sleep Center LLC | Clinic/Center | 2451 Riva Rd, Annapolis, MD 21401 | 2018-02-02 |
| Find all providers in zip 21401 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093342438 | Anne Arundel Physician Group LLC | Internal Medicine | 2003 Medical Pkwy Ste 350, Annapolis, MD 21401-3081 | 2020-03-25 |
| 1922442672 | Charles James Ganley | Internal Medicine | 2 Cambridge Ct, Annapolis, MD 21403-1607 | 2013-04-24 |
| 1215273842 | Nelson Gates Goodman | Internal Medicine | 940 Astern Way Unit 405, Annapolis, MD 21401-7502 | 2013-01-01 |
| 1740410216 | Owen Leigh Glister | Internal Medicine | 810 Bestgate Rd Ste 135, Annapolis, MD 21401-3033 | 2009-07-20 |
| 1851520936 | Josjin Vazhappilly | Internal Medicine | 2007 Tidewater Colony Dr, Suite 1 A, Annapolis, MD 21401-2101 | 2009-07-09 |
| 1518149046 | Kavita Iyengar | Internal Medicine | 108 Forbes Street, Second Floor, Annapolis, MD 21401-1501 | 2007-11-27 |
| 1366598898 | Andre S Colaco | Internal Medicine | 116 Defense Hwy Ste 400, Annapolis, MD 21401 | 2007-01-26 |
| 1245387414 | Julia L Surratt | Internal Medicine | 601 Burnside St, Annapolis, MD 21403-3216 | 2007-01-03 |
| 1003910324 | Eugene Thomas Manion | Internal Medicine | 900 Bestgate Road, Suite 303, Annapolis, MD 21401 | 2006-09-08 |
| 1154438497 | Thomas Fahed Hattar | Internal Medicine | 2009 Tidewater Colony Drive, Annapolis, MD 21401-0000 | 2006-08-24 |
| Find all providers in ANNAPOLIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.