Provider Demographics
NPI:1518957281
Name:MORALES, ANNA VICTORIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:VICTORIA
Last Name:MORALES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5995 OPUS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8387
Mailing Address - Country:US
Mailing Address - Phone:952-595-1220
Mailing Address - Fax:952-935-2757
Practice Address - Street 1:6923 WESTCOTT PL
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1710
Practice Address - Country:US
Practice Address - Phone:952-392-1100
Practice Address - Fax:952-935-2757
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2008-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00580922085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN248640GGMedicare PIN
DC134324ZA2KMedicare PIN