NPIMap

Organization Active NPI

Anne Arundel Dermatology, PA

  • Dermatology Physician
  • Glen Burnie, MD
National Provider Identifier
1114751260
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ANNE ARUNDEL DERMATOLOGY, PA
Practice address
810 Landmark Dr Ste 217-219
Glen Burnie, MD 21061-4987
Phone
(410) 766-0111
NPI assigned
Aug 30, 2024
Last updated
Aug 30, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ANNE ARUNDEL DERMATOLOGY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angela Ruth Peterman
Title
MD
Phone
(443) 351-3376

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

810 Landmark Dr Ste 217-219
Glen Burnie, MD 21061-4987

Mailing address

1306 Concourse Dr Ste 201
Linthicum Heights, MD 21090-1033

Other names 1

  • Anne Arundel Dermatology, PA Other name

National Provider Directory

National Provider Directory
Tax ID family
R L Handwerger MD PA36 organizations share this tax ID, including this one
Part of
R L Handwerger MD PA

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

810 Landmark Dr
Ste 217219
Glen Burnie, MD 21061
Phone (410) 766-0111

Interoperability endpoints

  • FHIR API: https://aadermaffiliates.mmi.prod.fhir.ema-api.com/fhir/r4

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1114751260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 CONCOURSE DR STE 201",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210901033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 LANDMARK DR STE 217-219",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614987",
            "telephone_number": "410-766-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNE ARUNDEL DERMATOLOGY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANNE ARUNDEL DERMATOLOGY, PA",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "PETERMAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "443-351-3376"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anne Arundel Dermatology, PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.