Basic Information
| Provider Information | |||||||||
| NPI: | 1386671899 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANNAPOLIS MEDICAL SPECIALISTS | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ANNAPOLIS ONCOLOGY CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 BESTGATE RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214013089 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105735300 | ||||||||
| FaxNumber: | 4102669645 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 BESTGATE RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214013089 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105735300 | ||||||||
| FaxNumber: | 4102669645 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | WERNER | ||||||||
| AuthorizedOfficialFirstName: | JEANINE | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 4105735300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.