Provider Demographics
NPI:1649213893
Name:GRADY, ANNE L (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:L
Last Name:GRADY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:8221 TEAL DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601
Mailing Address - Country:US
Mailing Address - Phone:410-820-6870
Mailing Address - Fax:410-820-0668
Practice Address - Street 1:8221 TEAL DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601
Practice Address - Country:US
Practice Address - Phone:410-820-6870
Practice Address - Fax:410-820-0668
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDH0047357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD213M285FMedicare PIN