Provider Demographics
NPI:1710178132
Name:SPRUNGER, ANNA CHIKOVANI (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:CHIKOVANI
Last Name:SPRUNGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:SHAVISHVILI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 37215
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-7215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-884-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical