Provider Demographics
NPI:1447977293
Name:ANNAPOLIS HEART LLC
Entity type:Organization
Organization Name:ANNAPOLIS HEART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELSJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHKULLAKU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-607-2299
Mailing Address - Street 1:129 LUBRANO DR STE 301
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7568
Mailing Address - Country:US
Mailing Address - Phone:443-607-2299
Mailing Address - Fax:443-782-3488
Practice Address - Street 1:129 LUBRANO DR STE 301
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7568
Practice Address - Country:US
Practice Address - Phone:443-607-2299
Practice Address - Fax:443-782-3488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty