Individual
DR. ANNE MARIAN PENNISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 VETERANS AVE, DEPARTMENT OF MEDICINE BILOXI VA (111), BILOXI, MS 39531-2410
(228) 523-5000
(228) 523-4515
Mailing address
PO BOX 3597, BAY ST LOUIS, MS 39521-3597
(228) 467-9877
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15051
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20649
MEDICAL LICENSE
LA
01
—
26110
MEDICAL LICENSE
AL
01
—
26749
MEDICAL LICENSE
SC
Enumeration date
07/18/2006
Last updated
07/08/2007
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