Individual
MRS. ANNIE VINCENT KANNARKAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
100 S CHARLES ST STE 150, BALTIMORE, MD 21201-2730
(410) 752-3010
Mailing address
100 S CHARLES ST STE 150, BALTIMORE, MD 21201-2730
(410) 752-3010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7527
GA
363A00000X
Physician Assistant
Primary
C06483
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7527
GA PHYSICIAN ASSISTANT LICENSE
GA
01
—
C06483
MD PHYSICIAN ASSISTANT LICENSE
MD
Enumeration date
07/08/2013
Last updated
07/21/2022
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