Provider Demographics
NPI:1003308859
Name:ANEA, BOGDAN CIPRIAN (MD)
Entity Type:Individual
Prefix:
First Name:BOGDAN
Middle Name:CIPRIAN
Last Name:ANEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 15TH ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:INTERMOUNTAIN KIDNEY SERVICES CLINIC
Practice Address - Street 2:5169 SOUTH COTTONWOOD STREET, SUITE 320
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:801-507-2531
Practice Address - Fax:801-507-2597
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13389719-1205207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology