NPIMap

Organization Active NPI

Anne Arundel Dermatology, P.a.

  • Specialist
  • Leonardtown, MD
National Provider Identifier
1639909310
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ANNE ARUNDEL DERMATOLOGY, P.A.
Practice address
23503 Hollywood Rd Ste 102
Leonardtown, MD 20650-5925
Phone
(443) 351-3376
Fax
(301) 475-1881
NPI assigned
Aug 6, 2024
Last updated
Aug 7, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ANNE ARUNDEL DERMATOLOGY, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 7, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

23503 Hollywood Rd Ste 102
Leonardtown, MD 20650-5925

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Robert Handwerger MD36 organizations share this tax ID, including this one
Part of
Robert Handwerger MD

Other organizations with this tax ID 35

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

View all 35

Locations

23503 Hollywood Rd
Ste 102
Leonardtown, MD 20650

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1639909310",
    "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": "23503 HOLLYWOOD RD STE 102",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206505925",
            "telephone_number": "443-351-3376",
            "fax_number": "301-475-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNE ARUNDEL DERMATOLOGY, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANNE ARUNDEL DERMATOLOGY, P.A.",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.