Provider Demographics
NPI:1184641870
Name:ALVANZO, ANIKA ADERO HARDIE (MD, MS)
Entity type:Individual
Prefix:DR
First Name:ANIKA
Middle Name:ADERO HARDIE
Last Name:ALVANZO
Suffix:
Gender:F
Credentials:MD, MS
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Mailing Address - Street 1:1040 PARK AVE STE 200
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5634
Mailing Address - Country:US
Mailing Address - Phone:443-738-0300
Mailing Address - Fax:443-738-0301
Practice Address - Street 1:1040 PARK AVE STE 200
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5634
Practice Address - Country:US
Practice Address - Phone:443-738-0300
Practice Address - Fax:443-738-0301
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD67688207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD415426600Medicaid
VA001050M84Medicare ID - Type UnspecifiedC03684