Provider Demographics
NPI:1922267632
Name:ANNAS, GEORGE DAVID (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:DAVID
Last Name:ANNAS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 NOYES ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-3854
Mailing Address - Country:US
Mailing Address - Phone:315-738-2651
Mailing Address - Fax:315-738-4410
Practice Address - Street 1:1400 NOYES ST
Practice Address - Street 2:YSC
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-3854
Practice Address - Country:US
Practice Address - Phone:315-738-2651
Practice Address - Fax:315-738-4410
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2618082084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA233467OtherEDUCATIONAL LIMITED LIC.
MA233467OtherEDUCATIONAL LIMITED LIC.