Provider Demographics
NPI:1780790253
Name:SARANTE, ANA IDELCA (MEDICAL DOCTOR)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:IDELCA
Last Name:SARANTE
Suffix:
Gender:F
Credentials:MEDICAL DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 LIBERTY RD STE 204
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6542
Mailing Address - Country:US
Mailing Address - Phone:410-795-7737
Mailing Address - Fax:410-795-2828
Practice Address - Street 1:1645 LIBERTY RD STE 204
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6542
Practice Address - Country:US
Practice Address - Phone:410-795-7737
Practice Address - Fax:410-795-2828
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059054207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401223200Medicaid
MDH72799Medicare UPIN
MD401223200Medicaid