Provider Demographics
NPI:1093764615
Name:KESHWANI, ANISH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANISH
Middle Name:
Last Name:KESHWANI
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 1:840 E UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2304
Mailing Address - Country:US
Mailing Address - Phone:515-265-4211
Mailing Address - Fax:515-309-5993
Practice Address - Street 1:840 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2304
Practice Address - Country:US
Practice Address - Phone:515-265-4211
Practice Address - Fax:515-309-5993
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-32831207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1093764615Medicaid
IA8186684Medicaid
IAP00428827OtherRR MEDICARE PIN
IA080144761OtherRR MEDICARE
IAP0107776OtherRR MEDICARE
IA1093764615Medicaid
IAG68809Medicare UPIN
IA719260411Medicare PIN