Provider Demographics
NPI:1568573087
Name:ANUSH A JOHN DMD MD PA
Entity Type:Organization
Organization Name:ANUSH A JOHN DMD MD PA
Other - Org Name:DRS. ABELSON & CAMERON
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-337-7755
Mailing Address - Street 1:1212 YORK RD
Mailing Address - Street 2:SUITE A 201
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6240
Mailing Address - Country:US
Mailing Address - Phone:410-337-7755
Mailing Address - Fax:410-337-7922
Practice Address - Street 1:1212 YORK RD
Practice Address - Street 2:SUITE A 201
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093
Practice Address - Country:US
Practice Address - Phone:410-337-7755
Practice Address - Fax:410-337-7922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD155301223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH369I747Medicare UPIN