Provider Demographics
NPI:1306576434
Name:ANNA B MCCALL MD LLC
Entity type:Organization
Organization Name:ANNA B MCCALL MD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-850-2069
Mailing Address - Street 1:4000 MITCHELLVILLE RD STE A308
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3135
Mailing Address - Country:US
Mailing Address - Phone:301-850-2069
Mailing Address - Fax:301-893-7584
Practice Address - Street 1:4000 MITCHELLVILLE RD STE A308
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3135
Practice Address - Country:US
Practice Address - Phone:017-588-9293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD355028100Medicaid
MD1306092135Medicaid