Provider Demographics
NPI:1326083940
Name:ANE, EVELINE BIYOGA (MD)
Entity Type:Individual
Prefix:
First Name:EVELINE
Middle Name:BIYOGA
Last Name:ANE
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 1:8116 GOOD LUCK RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3502
Mailing Address - Country:US
Mailing Address - Phone:301-552-1200
Mailing Address - Fax:301-552-1202
Practice Address - Street 1:7219 HANOVER PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2021
Practice Address - Country:US
Practice Address - Phone:301-486-7580
Practice Address - Fax:301-486-7581
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD411852900Medicaid
020645Medicare PIN