Individual
DR. ANA PONCE KIESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
401 S BROADWAY, SUITE 1440, BALTIMORE, MD 21231-2431
(443) 287-7528
(410) 502-1419
Mailing address
401 NORTH BROADWAY, SUITE 1440, BALTIMORE, MD 21231
(443) 287-7528
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
D75730
MD
2085R0203X
Therapeutic Radiology Physician
D0075730
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069086400
—
MD
01
—
230340
GROUP MC PTAN
MD
Enumeration date
06/23/2008
Last updated
12/18/2014
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