Individual
SUZETTE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
DR. SHAFQUAT MERAJ MDPA, 1015 PRINCE FREDERICK BLVD., PRINCE FREDERICK, MD 20678
(410) 535-4116
Mailing address
1015 PRINCE FREDERICK BLVD, PRINCE FREDERICK, MD 20678-3193
(410) 535-4116
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R148987
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386258929
UROLOGY
MD
05
—
184189100
—
MD
Enumeration date
09/01/2020
Last updated
01/24/2023
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