Gonzaga, Anna Marie

Gonzaga, Anna Marie is an individual health care provider with primary practice located at 4940 Eastern Ave , Baltimore MD 21224-2735. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Gonzaga, Anna Marie can be contacted via phone (410) 550-0016.

Contact Information

Primary practice address
4940 Eastern Ave Baltimore MD 21224-2735
Phone: (410) 550-0016
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X D57544 Maryland
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X D57544 Maryland

Profile Details

NPI number 1013960608
LBN Legal business name Gonzaga, Anna Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Jan 23rd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013960608 NPPES
Maryland MEDICAID 402634900

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