Provider Demographics
NPI:1841226396
Name:BULATOVIC, ANNAMARIA (MD)
Entity Type:Individual
Prefix:
First Name:ANNAMARIA
Middle Name:
Last Name:BULATOVIC
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:PO BOX 630896
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-0896
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 N CALVERT ST
Practice Address - Street 2:MEAD BLDG, 1ST FLOOR PEDS
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3611
Practice Address - Country:US
Practice Address - Phone:410-500-5500
Practice Address - Fax:410-659-5691
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044517208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS034 / 528434-03OtherBC / BS OF MD
MDW531 / 0031OtherBLUECHOICE
MDW531 / 0031OtherBLUECHOICE
E99376Medicare UPIN