Provider Demographics
NPI:1760123558
Name:CARRANZA, ABIGAIL A (DO)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:A
Last Name:CARRANZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7580 BUCKINGHAM BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-3210
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:
Practice Address - Street 1:129 LUBRANO DR STE 100
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7566
Practice Address - Country:US
Practice Address - Phone:410-266-5852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0104146207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program