Provider Demographics
NPI:1801100797
Name:BEARD, ANA M (PA-C)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:BEARD
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 64664
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4664
Mailing Address - Country:US
Mailing Address - Phone:410-550-8551
Mailing Address - Fax:
Practice Address - Street 1:10753 FALLS RD STE 215
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4597
Practice Address - Country:US
Practice Address - Phone:410-583-2850
Practice Address - Fax:410-583-2855
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC0004268363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD802380Y1KMedicare PIN