Provider Demographics
NPI:1619917028
Name:CUMMINGS, ANNE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S ELISEO DR
Mailing Address - Street 2:STE. 201
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2023
Mailing Address - Country:US
Mailing Address - Phone:415-461-5552
Mailing Address - Fax:415-464-8964
Practice Address - Street 1:1300 S ELISEO DR
Practice Address - Street 2:STE. 201
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2023
Practice Address - Country:US
Practice Address - Phone:415-461-5552
Practice Address - Fax:415-464-8964
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61715207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA001617152OtherPTAN, INDIVIDUAL
CAZZZ05516ZOtherPTAN, GROUP
CA001617152OtherPTAN, INDIVIDUAL