Provider Demographics
NPI:1164400230
Name:ANAND, AJAY (MD)
Entity Type:Individual
Prefix:
First Name:AJAY
Middle Name:
Last Name:ANAND
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:PO BOX 126
Mailing Address - Street 2:1500 TERRACE STREET
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-0126
Mailing Address - Country:US
Mailing Address - Phone:304-466-1660
Mailing Address - Fax:304-466-2917
Practice Address - Street 1:115 SUMMERS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-5172
Practice Address - Country:US
Practice Address - Phone:304-466-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21114207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVG25136Medicare UPIN