Provider Demographics
NPI:1750358370
Name:ANADU, JULIET (MD)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:ANADU
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 1:10 SAINT PATRICKS DR STE 105
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-5527
Mailing Address - Country:US
Mailing Address - Phone:301-645-1414
Mailing Address - Fax:301-645-4586
Practice Address - Street 1:10 SAINT PATRICKS DR STE 105
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-5527
Practice Address - Country:US
Practice Address - Phone:301-645-1414
Practice Address - Fax:301-645-4586
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0039342174400000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
F97431Medicare UPIN