Provider Demographics
NPI:1982669115
Name:ANANT, MEENA CHANDRASEKARAN (MD)
Entity Type:Individual
Prefix:
First Name:MEENA
Middle Name:CHANDRASEKARAN
Last Name:ANANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MEENAKSHI
Other - Middle Name:H
Other - Last Name:CHANDRASEKARAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3600 LEONARDTOWN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3647
Mailing Address - Country:US
Mailing Address - Phone:301-843-3062
Mailing Address - Fax:301-843-2384
Practice Address - Street 1:3600 LEONARDTOWN RD STE 101
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3647
Practice Address - Country:US
Practice Address - Phone:301-843-3062
Practice Address - Fax:301-843-2384
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054760208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
141803Medicare UPIN