Basic Information
| Provider Information | |||||||||
| NPI: | 1215976600 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOLGUERAS | ||||||||
| FirstName: | ANNETTE | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 64374 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212644374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2099567725 | ||||||||
| FaxNumber: | 4103281674 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 CRAIN HWY S STE 208 | ||||||||
| Address2: | |||||||||
| City: | GLEN BURNIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210616438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107680262 | ||||||||
| FaxNumber: | 4107687730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2006 | ||||||||
| LastUpdateDate: | 12/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 042-0015448 | VT | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | D0047031 | MD | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 699940900 | 05 | MD | MEDICAID | CA8702 | 01 | MD | RAILROAD MEDICARE GROUP | OTHER |