Provider Demographics
NPI:1053330662
Name:PANE, MARIA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ANN
Last Name:PANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 631568
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-1568
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:DEPT OF NEONATAL MEDICINE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:443-849-2792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD46156208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4700503OtherGBMC UHC AMERICHOICE
MD2120199OtherGBMC MAMSI
MD94109OtherGBMC AMERIGROUP
MD23620OtherGBMC HOPKINS PRODUCTS
MDKJ50GB/533934-02OtherCAREFIRST MARYLAND
MD233054OtherGBMC KAISER PERM
MDS1390014OtherCAREFIRST REGIONAL GBMC
MD23620OtherGBMC HOPKINS PRODUCTS
MDS1390014OtherCAREFIRST REGIONAL GBMC