Provider Demographics
NPI:1497779441
Name:GIANNANDREA, PAUL FRANK (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:FRANK
Last Name:GIANNANDREA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1300 YORK RD
Mailing Address - Street 2:C 300
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6016
Mailing Address - Country:US
Mailing Address - Phone:410-525-6984
Mailing Address - Fax:443-519-5167
Practice Address - Street 1:1300 YORK RD
Practice Address - Street 2:C 300
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6016
Practice Address - Country:US
Practice Address - Phone:410-525-6984
Practice Address - Fax:443-519-5167
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00239732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBR15Medicare PIN
MDB70375Medicare UPIN