Individual
DR. ANNE ENCARNACION AGRAVIADOR CONSTANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6900 N PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(301) 877-4540
(301) 856-3470
Mailing address
10401 HOSPITAL DR, SUITE 102, CLINTON, MD 20735-3110
(301) 877-4540
(301) 856-3470
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
38548
KY
2084N0400X
Neurology Physician
Primary
D0074007
MD
2084N0400X
Neurology Physician
MD043238
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312507600
—
MD
01
—
342916ZAPQ
MEDICARE GROUP MEMBER PTAN
MD
Enumeration date
03/14/2006
Last updated
08/03/2023
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