Provider Demographics
NPI:1801955976
Name:RABBANI, ANNA N (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:N
Last Name:RABBANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:ALEXANDRA
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:19775 IDA LN W
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2523
Mailing Address - Country:US
Mailing Address - Phone:703-786-3978
Mailing Address - Fax:
Practice Address - Street 1:19229 MACK AVE STE 10
Practice Address - Street 2:RADIATION ONCOLOGY SPECIALISTS
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-2857
Practice Address - Country:US
Practice Address - Phone:313-647-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN82702085R0001X
MI43010890162085R0001X
MI43011043072085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology