Individual
ANJA OCTAVIA LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
50 ROOSEVELT TER, WILKES BARRE, PA 18702-3517
(570) 808-8780
(570) 808-8785
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101233487
VA
207Q00000X
Family Medicine Physician
Primary
MD445002
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027272920001
—
PA
Enumeration date
07/25/2006
Last updated
08/13/2020
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