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ANNE ARUNDEL DERMATOLOGY, P.A.
NPI 1083448039
Dermatology - MOHS-Micrographic Surgery in Annapolis, MD

Active since August 30, 2024CLIA Certified · 10 labs
180 ADMIRAL COCHRANE DR STE 430, ANNAPOLIS, MD 21401(410) 263-5439 Get Directions Write a Review

NPPES record last updated: August 30, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Anne Arundel Dermatology, P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANNE ARUNDEL DERMATOLOGY, P.A. (NPI 1083448039) is a healthcare organization registered as a mohs-micrographic surgery in Annapolis, Maryland and active in the NPI registry since August 2024. The organization holds 10 active CLIA laboratory certificates and lists Angela Ruth Peterman, Md, as its authorized official.

NPPES Registry Identity

NPI1083448039
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameANNE ARUNDEL DERMATOLOGY, P.A.
Location Address180 ADMIRAL COCHRANE DR STE 430Annapolis, MD 21401-8405
Mailing Address1306 Concourse Dr Ste 201Linthicum Heights, MD 21090-1033
Phone(410) 263-5439
Organization SubpartYes
Authorized OfficialAngela Ruth PetermanMd · (443) 351-3376
Enumeration DateAugust 30, 2024
NPPES CertifiedAugust 30, 2024
✔ NPI 1083448039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Also ListedSpecialistTaxonomy 174400000X
Also ListedDermatologyTaxonomy 207N00000X
180 ADMIRAL COCHRANE DR STE 430, Annapolis, MD 21401
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Other Names 2

Other NameAnne Arundel Dermatology, P.a.
Other NameAnne Arundel Dermatology, Pa

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 10

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 21D0685343

Anne Arundel Dermatology PA · Annapolis, MD
Active · expires Aug 21, 2027
CLIA Number21D0685343
Laboratory TypePhysician Office
Certificate Effective DateAugust 22, 2025
Certificate Expiration DateAugust 21, 2027
Laboratory DirectorJason Marquart
Laboratory Phone(410) 263-5439
Laboratory LocationAnne Arundel Dermatology PA180 Admiral Cochrane Drive Suite 430, Annapolis, MD 21401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 21D2125218

Anne Arundel Dermatology · Westminster, MD
Active · expires Jun 19, 2028
CLIA Number21D2125218
Laboratory TypePhysician Office
Certificate Effective DateJune 20, 2026
Certificate Expiration DateJune 19, 2028
Laboratory DirectorJuris P. Germanas
Laboratory Phone(410) 263-5439
Laboratory LocationAnne Arundel Dermatology410 Meadow Creek Dr Ste 205, Westminster, MD 21158
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D2107208

Anne Arundel Dermatology · Towson, MD
Active · expires Jan 7, 2028
CLIA Number21D2107208
Laboratory TypePhysician Office
Certificate Effective DateJanuary 8, 2026
Certificate Expiration DateJanuary 7, 2028
Laboratory DirectorDavis G. Farvolden
Laboratory Phone(410) 263-5439
Laboratory LocationAnne Arundel Dermatology810 Gleneagles Court Suite 204, Towson, MD 21286
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 49D2154315

Anne Arundel Dermatology · Fairfax, VA
Active · expires Dec 31, 2027
CLIA Number49D2154315
Laboratory TypePhysician Office
Certificate Effective DateJanuary 1, 2026
Certificate Expiration DateDecember 31, 2027
Laboratory DirectorMonica N. Valentin
Laboratory Phone(410) 263-5439
Laboratory LocationAnne Arundel Dermatology11351 Random Hills Road, Suite 200, Fairfax, VA 22030
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D2126150

Anne Arundel Dermatology · Columbia, MD
Active · expires Feb 20, 2027
CLIA Number21D2126150
Laboratory TypePhysician Office
Certificate Effective DateFebruary 21, 2025
Certificate Expiration DateFebruary 20, 2027
Laboratory DirectorChikoti Wheat
Laboratory Phone(410) 263-5439
Laboratory LocationAnne Arundel Dermatology10700 Charter Drive, Columbia, MD 21044
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D2125202

Anne Arundel Dermatology · Sykesville, MD
Active · expires Feb 1, 2027
CLIA Number21D2125202
Laboratory TypePhysician Office
Certificate Effective DateFebruary 2, 2025
Certificate Expiration DateFebruary 1, 2027
Laboratory DirectorJuris Germanas
Laboratory Phone(410) 263-5439
Laboratory LocationAnne Arundel Dermatology5977 Exchange Drive #c-D, Sykesville, MD 21784
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE BONANNI PA-C
Physician Assistant
180 ADMIRAL COCHRANE DR STE 430
ANNAPOLIS, MD 21401
Anne Arundel County (410) 339-0760
ANNE ARUNDEL DERMATOLOGY
Dermatology (MOHS-Micrographic Surgery)
180 ADMIRAL COCHRANE DR STE 430
ANNAPOLIS, MD 21401
Anne Arundel County (410) 263-5439
MARCUS ZAAYMAN MD
Dermatology (MOHS-Micrographic Surgery)
180 ADMIRAL COCHRANE DR STE 430
ANNAPOLIS, MD 21401
Anne Arundel County (410) 339-0760

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Anne Arundel Dermatology, P.A.'s NPI number?

The NPI number for Anne Arundel Dermatology, P.A. is 1083448039. It was assigned to this organization in the NPPES registry on August 30, 2024. The provider is also known as Anne Arundel Dermatology, PA.

Where is Anne Arundel Dermatology, P.A. located?

Anne Arundel Dermatology, P.A. is located at 180 Admiral Cochrane Dr Ste 430, Annapolis, MD 21401. The listed phone number is (410) 263-5439.

What is Anne Arundel Dermatology, P.A.'s specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Anne Arundel Dermatology, P.A. hold CLIA laboratory certificates?

Yes. 10 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Anne Arundel Dermatology, P.A. was last updated on August 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.