Provider Demographics
NPI:1306949813
Name:PLOEN, MAUREEN ANNE (MA PAC)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:ANNE
Last Name:PLOEN
Suffix:
Gender:F
Credentials:MA PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2002 MEDICAL PARKWAY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3046
Mailing Address - Country:US
Mailing Address - Phone:410-451-1198
Mailing Address - Fax:410-451-1198
Practice Address - Street 1:2002 MEDICAL PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3046
Practice Address - Country:US
Practice Address - Phone:410-571-9000
Practice Address - Fax:410-571-1670
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC0002673363A00000X
VA0110001668363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD320MK246Medicare PIN
Q31104Medicare UPIN