Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 0101244863 | VA |
Y | 207N00000X | Dermatologist | D77702 | MD |
NPI | 1043415789 |
---|---|
Provider Name | Dr. Anne Patricia Spillane |
First Address | Berlin, MD 21811-1215 |
Second Address | Berlin, MD 21811-1215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 09/06/2015 |