Provider Demographics
NPI:1679643076
Name:ANAGNOS, DARIA J (MD)
Entity Type:Individual
Prefix:
First Name:DARIA
Middle Name:J
Last Name:ANAGNOS
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 1:420 COTTON GIN RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3557
Mailing Address - Country:US
Mailing Address - Phone:334-260-9129
Mailing Address - Fax:334-260-9665
Practice Address - Street 1:420 COTTON GIN RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3557
Practice Address - Country:US
Practice Address - Phone:334-260-9129
Practice Address - Fax:334-260-9665
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10749208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC76546Medicare UPIN