Individual
TASHA MONIQUE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4300 BELAIR RD STE A, BALTIMORE, MD 21206-6300
(410) 325-2100
(410) 630-5130
Mailing address
5606 BELLEVILLE AVE, GWYNN OAK, MD 21207-6946
(347) 432-7522
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
013877
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05296
MARYLAND LICENSE
MD
Enumeration date
02/26/2010
Last updated
07/21/2022
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