Provider Demographics
NPI:1285837963
Name:CZAJKA, ANNA TERESA (MD)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:TERESA
Last Name:CZAJKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:TERESA
Other - Last Name:CZAJKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3339
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22402-3339
Mailing Address - Country:US
Mailing Address - Phone:855-739-9953
Mailing Address - Fax:888-463-3944
Practice Address - Street 1:1201 SAM PERRY BLVD STE 205
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4490
Practice Address - Country:US
Practice Address - Phone:855-739-9953
Practice Address - Fax:888-463-3944
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101247593207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCC06380OtherMEDICARE VA PTAN
VAG00773OtherMEDICARE DC PTAN