Provider Demographics
NPI:1164580171
Name:GHOSH, ANINDITA (MD)
Entity Type:Individual
Prefix:
First Name:ANINDITA
Middle Name:
Last Name:GHOSH
Suffix:
Gender:F
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 16370
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43216-6370
Mailing Address - Country:US
Mailing Address - Phone:614-645-5500
Mailing Address - Fax:614-645-5517
Practice Address - Street 1:2300 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3783
Practice Address - Country:US
Practice Address - Phone:614-645-2300
Practice Address - Fax:614-645-2333
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002647207R00000X
OH35092313207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2912290Medicaid
OH2912290Medicaid
OHH035504Medicare PIN