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ANNE ARUNDEL DERMATOLOGY, P.A.
NPI 1215767991
Specialist in Hagerstown, MD

Active since August 06, 2024CLIA 21D2079951 · Certificate of Compliance
1185 IMPERIAL DR STE 201, HAGERSTOWN, MD 21740(443) 351-3376(301) 791-5234 Get Directions Write a Review

NPPES record last updated: August 7, 2024. Verified against the NPPES registry weekly; last sync: July 19, 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 1215767991) is a healthcare organization registered as a specialist in Hagerstown, Maryland and active in the NPI registry since August 2024. The organization holds a CLIA Certificate of Compliance certificate valid through November 18, 2026 and lists Angela Ruth Peterman, Md, as its authorized official.

NPPES Registry Identity

NPI1215767991
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameANNE ARUNDEL DERMATOLOGY, P.A.
Location Address1185 IMPERIAL DR STE 201Hagerstown, MD 21740-6673
Mailing Address1306 Concourse Dr Ste 201Linthicum Heights, MD 21090-1033
Phone(443) 351-3376
Fax(301) 791-5234
Organization SubpartYes
Authorized OfficialAngela Ruth PetermanMd · (443) 351-3376
Enumeration DateAugust 6, 2024
Last NPPES UpdateAugust 7, 2024
NPPES CertifiedAugust 7, 2024
✔ NPI 1215767991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

1185 IMPERIAL DR STE 201, Hagerstown, MD 21740
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 21D2079951

Anne Arundel Dermatology · Hagerstown, MD
Active · expires Nov 18, 2026
CLIA Number21D2079951
Laboratory TypePhysician Office
Certificate Effective DateNovember 19, 2024
Certificate Expiration DateNovember 18, 2026
Laboratory DirectorBrandon Mitchell
Laboratory Phone(410) 263-7482
Laboratory LocationAnne Arundel Dermatology1185 Imperial Drive Ste 201, Hagerstown, MD 21740
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES

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

JENNIFER BACHER PHYSICIAN ASSISTANT
Physician Assistant (Medical)
1185 IMPERIAL DR STE 201
HAGERSTOWN, MD 21740
Washington County (443) 351-3376

Frequently Asked Questions

What is ANNE ARUNDEL DERMATOLOGY, P.A.'s NPI number?

The NPI number assigned to this healthcare provider is 1215767991, enumerated as an "organization" on August 06, 2024.

Where is the provider located?

The provider is located at 1185 IMPERIAL DR STE 201 HAGERSTOWN, MD 21740 and the phone number is (443) 351-3376.

What is the provider's specialty?

Specialist with taxonomy code 174400000X.