Provider Demographics
NPI:1710357454
Name:EINWALTER, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:EINWALTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9106 SANDRA CT
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-3317
Mailing Address - Country:US
Mailing Address - Phone:443-675-8274
Mailing Address - Fax:
Practice Address - Street 1:11729 BELTSVILLE DR
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3147
Practice Address - Country:US
Practice Address - Phone:888-694-7287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist