Provider Demographics
NPI:1770876054
Name:SIDOROWICZ, NANCY ANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:SIDOROWICZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7250 PARKWAY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1388
Mailing Address - Country:US
Mailing Address - Phone:410-567-5520
Mailing Address - Fax:410-712-4760
Practice Address - Street 1:7250 PARKWAY DR
Practice Address - Street 2:SUITE 400
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1388
Practice Address - Country:US
Practice Address - Phone:410-567-5520
Practice Address - Fax:410-712-4760
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001472363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical