Provider Demographics
NPI:1770741746
Name:DUTTA, ANAND (MD)
Entity type:Individual
Prefix:DR
First Name:ANAND
Middle Name:
Last Name:DUTTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 S LUZERNE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3715
Mailing Address - Country:US
Mailing Address - Phone:410-440-3179
Mailing Address - Fax:
Practice Address - Street 1:2350 FREEDOM WAY STE 200
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-8200
Practice Address - Country:US
Practice Address - Phone:717-812-5120
Practice Address - Fax:717-741-3075
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD68601208M00000X
PAMD461762207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist