Provider Demographics
NPI:1043578818
Name:ANIL, CLARA RIJI (MD)
Entity Type:Individual
Prefix:MRS
First Name:CLARA RIJI
Middle Name:
Last Name:ANIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLARA RIJI
Other - Middle Name:
Other - Last Name:NEDUMBAKARAN GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1055 N CURTIS RD
Mailing Address - Street 2:SAMG INTERNAL MEDICINE HOSPITALISTS
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-1309
Mailing Address - Country:US
Mailing Address - Phone:208-367-7350
Mailing Address - Fax:
Practice Address - Street 1:1055 N CURTIS RD
Practice Address - Street 2:SAMG INTERNAL MEDICINE HOSPITALISTS
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1309
Practice Address - Country:US
Practice Address - Phone:208-367-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IDM 12946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program