Organization
ANNE ARUNDEL DERMATOLOGY, PA
Active
Parent organization
ANNE ARUNDEL DERMATOLOGY, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANNE ARUNDEL DERMATOLOGY, PA
Authorized official
NICOLE PROFFITT (DIR OF CREDENTIALING ENROLLMENT)
(804) 869-6269
Entity
Organization
Contact information
Practice address
810 LANDMARK DR STE 120-122, GLEN BURNIE, MD 21061-4987
(443) 351-3376
(410) 766-4177
Mailing address
PO BOX 23329, NEW YORK, NY 10087-3329
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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