Provider Demographics
NPI:1114922515
Name:JHANGIANI, ANIL H (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:H
Last Name:JHANGIANI
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 1:325 N MAIN ST
Mailing Address - Street 2:STE. 206
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-8005
Mailing Address - Country:US
Mailing Address - Phone:937-619-0101
Mailing Address - Fax:
Practice Address - Street 1:325 N MAIN ST
Practice Address - Street 2:STE. 206
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-8005
Practice Address - Country:US
Practice Address - Phone:937-619-0101
Practice Address - Fax:937-619-0408
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-2547207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2019185Medicaid
OHP00477084OtherRAILROAD MEDICARE
OHG22506Medicare UPIN
OHJH4175061Medicare ID - Type Unspecified