Provider Demographics
NPI:1679519615
Name:MONIAS, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MONIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 RESEARCH PARK DR # 4
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4873
Mailing Address - Country:US
Mailing Address - Phone:410-402-2258
Mailing Address - Fax:410-204-7279
Practice Address - Street 1:6701 N CHARLES ST STE 4105
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:443-849-3184
Practice Address - Fax:443-849-3182
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058646207R00000X
MDD58646207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
9676-0024OtherCAREFIRST BCBS OF DC
MD61573302OtherBCBS OF MD
0405128OtherEVERCARE
MD0034OtherBCBS
093NER-615733-02OtherCAREFIRST BCBS OF MD
MD008203101Medicaid
0943ER-615733-03OtherCAREFIRST BCBS OF MD
MD522096682OtherTRICARE
093NSE-615733-02OtherCAREFIRST BCBS OF MD
MD367650100Medicaid
MD008203101Medicaid
093NER-615733-02OtherCAREFIRST BCBS OF MD
0405128OtherEVERCARE