Provider Demographics
NPI:1528068053
Name:TALUSAN, ANNABELLE B (MD)
Entity type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:B
Last Name:TALUSAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 CHESAPEAKE DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-9408
Mailing Address - Country:US
Mailing Address - Phone:410-901-4000
Mailing Address - Fax:410-901-4011
Practice Address - Street 1:830 CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-9408
Practice Address - Country:US
Practice Address - Phone:410-901-4000
Practice Address - Fax:410-901-4011
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND7997207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND10599Medicaid
ND21348Medicare ID - Type Unspecified
ND10599Medicaid