Provider Demographics
NPI:1346266376
Name:ZEMELSHTERN, ANNA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:ZEMELSHTERN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:RAKHUNOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:6412 REISTERSTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2308
Mailing Address - Country:US
Mailing Address - Phone:410-764-9360
Mailing Address - Fax:410-764-3229
Practice Address - Street 1:6412 REISTERSTOWN ROAD
Practice Address - Street 2:CHARM CITY OPTICAL
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2308
Practice Address - Country:US
Practice Address - Phone:410-764-9360
Practice Address - Fax:410-764-3229
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1943152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407758000Medicaid
MD235P5116Medicare ID - Type Unspecified
MD407758000Medicaid