Provider Demographics
NPI:1447500707
Name:ASHFORD, MICHAEL-ANNE (PA-C)
Entity type:Individual
Prefix:MS
First Name:MICHAEL-ANNE
Middle Name:
Last Name:ASHFORD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 WALDORF CT
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2317
Mailing Address - Country:US
Mailing Address - Phone:773-425-1414
Mailing Address - Fax:
Practice Address - Street 1:2002 MEDICAL PKWY
Practice Address - Street 2:STE 500
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3046
Practice Address - Country:US
Practice Address - Phone:410-573-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004784363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical