Provider Demographics
NPI:1467492058
Name:ANDERSON, CYNTHIA ROSEBERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ROSEBERRY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:ROSEBERRY
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2041 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20060-3002
Mailing Address - Country:US
Mailing Address - Phone:202-595-3200
Mailing Address - Fax:202-332-1781
Practice Address - Street 1:2041 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-3002
Practice Address - Country:US
Practice Address - Phone:202-595-3200
Practice Address - Fax:202-332-1781
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD20984207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F97566Medicare UPIN