Provider Demographics
NPI:1508205352
Name:PEREZ, ANA A (DC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:A
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 LIVINGSTON ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744
Mailing Address - Country:US
Mailing Address - Phone:240-766-0300
Mailing Address - Fax:240-766-0304
Practice Address - Street 1:4301 GARDEN CITY DR
Practice Address - Street 2:SUITE 104
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-2210
Practice Address - Country:US
Practice Address - Phone:301-577-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor