1780683813 NPI number — DR. JOAN CANTERO-LAKHANPAL MD

Table of content: DR. JOAN CANTERO-LAKHANPAL MD (NPI 1780683813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780683813 NPI number — DR. JOAN CANTERO-LAKHANPAL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CANTERO-LAKHANPAL
Provider First Name:
JOAN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CANTERO
Provider Other First Name:
JOAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780683813
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 64131
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21264-4131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-481-6480
Provider Business Mailing Address Fax Number:
443-481-6515

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 FORBES ST
Provider Second Line Business Practice Location Address:
SECOND FLOOR
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-1502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-571-7880
Provider Business Practice Location Address Fax Number:
410-571-0362
Provider Enumeration Date:
07/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  D0053468 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3072419 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60604405 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5495620 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60604407 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60604408 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60604410 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0001 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300340 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 400734404129917400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 60604406 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60604409 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".




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