Provider Demographics
NPI:1285824904
Name:CUTINHA, ANNIKA HONARENE (MBBS)
Entity Type:Individual
Prefix:DR
First Name:ANNIKA
Middle Name:HONARENE
Last Name:CUTINHA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:11402 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-7557
Practice Address - Country:US
Practice Address - Phone:864-631-2799
Practice Address - Fax:864-522-1215
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC86204207RR0500X
TNMD051592207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ006910Medicaid
SCPENDINGMedicaid