Provider Demographics
NPI:1164716791
Name:BEAVIS, ANNA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:LOUISE
Last Name:BEAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE STREET
Practice Address - Street 2:PHIPPS 281
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-8240
Practice Address - Fax:410-614-8718
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2019-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD79157207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology