Individual
DR. ANNUKKA ANTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
1717 E MONUMENT ST, BALTIMORE, MD 21287-0027
(410) 955-1725
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D79266
MD
207R00000X
Internal Medicine Physician
DR0052386
CO
207RI0200X
Infectious Disease Physician
D79266
MD
208M00000X
Hospitalist Physician
0052386
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025520600
—
NE
05
—
136743900
—
WY
05
—
80001271
—
CO
01
—
P01299635
RR MEDICARE
CO
Enumeration date
04/14/2010
Last updated
10/06/2022
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