Individual
REGINA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4100 N CHARLES STREET, SUITE 114, BALTIMORE, MD 21218
(410) 889-7600
(410) 889-7699
Mailing address
4100 N CHARLES STREET, SUITE 114, BALTIMORE, MD 21218
(410) 889-7600
(410) 889-7699
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
D23825
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004266216
AETNA
—
Enumeration date
05/17/2006
Last updated
11/05/2007
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