Provider Demographics
NPI:1780683813
Name:CANTERO-LAKHANPAL, JOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:CANTERO-LAKHANPAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOAN
Other - Middle Name:
Other - Last Name:CANTERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 64131
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4131
Mailing Address - Country:US
Mailing Address - Phone:443-481-6480
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:108 FORBES ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1502
Practice Address - Country:US
Practice Address - Phone:410-571-7880
Practice Address - Fax:410-571-0362
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053468207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
3072419OtherAETNA HMO
60604405OtherCAREFIRST
5495620OtherAETNA PPO
60604407OtherCAREFIRST
60604408OtherCAREFIRST
60604410OtherCAREFIRST
0001OtherCAREFIRST
300340OtherUHC
MD400734404129917400Medicaid
60604406OtherCAREFIRST
60604409OtherCAREFIRST
0001OtherCAREFIRST
60604410OtherCAREFIRST
460003883Medicare PIN
223903ZA84Medicare PIN