Provider Demographics
NPI:1154307684
Name:GEORGE, ANIL (MD)
Entity Type:Individual
Prefix:MR
First Name:ANIL
Middle Name:
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:ANIL
Other - Middle Name:
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:700 SHADOW LANE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106
Mailing Address - Country:US
Mailing Address - Phone:702-384-0022
Mailing Address - Fax:702-384-0529
Practice Address - Street 1:2100 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2818
Practice Address - Country:US
Practice Address - Phone:252-847-3858
Practice Address - Fax:702-384-0529
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500792207R00000X
NV15900207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901294Medicaid
NC139T2OtherBCBS NC
NC139T2OtherBCBS NC
NC5901294Medicaid