Provider Demographics
NPI:1528949385
Name:ANNAPOLIS RHEUMATOLOGY LLC
Entity type:Organization
Organization Name:ANNAPOLIS RHEUMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:CHERIAN
Authorized Official - Last Name:JACOB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-367-3235
Mailing Address - Street 1:166 DEFENSE HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8922
Mailing Address - Country:US
Mailing Address - Phone:410-897-1941
Mailing Address - Fax:
Practice Address - Street 1:18 MAGOTHY BEACH RD STE B
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4477
Practice Address - Country:US
Practice Address - Phone:410-897-1941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNAPOLIS RHEUMATOLOGY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty