Provider Demographics
NPI:1033514781
Name:ANACOSTIA MULTISPECIALTY PARTNERS
Entity Type:Organization
Organization Name:ANACOSTIA MULTISPECIALTY PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILAD
Authorized Official - Middle Name:
Authorized Official - Last Name:POORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-373-5840
Mailing Address - Street 1:8408 ADLER CT
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1771
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8500 ANNAPOLIS RD STE 100
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3021
Practice Address - Country:US
Practice Address - Phone:240-667-2099
Practice Address - Fax:240-764-5175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty