Provider Demographics
NPI:1295821585
Name:JAIN, ANUJ (MD)
Entity Type:Individual
Prefix:
First Name:ANUJ
Middle Name:
Last Name:JAIN
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 6607
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0607
Mailing Address - Country:US
Mailing Address - Phone:402-483-3333
Mailing Address - Fax:
Practice Address - Street 1:1600 S 48TH ST STE 600
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1275
Practice Address - Country:US
Practice Address - Phone:402-483-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20428207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0567552Medicaid
NE47070592301Medicaid
NE47070592302Medicaid
NE47070592305Medicaid
NE47070592306Medicaid
NE10026072200Medicaid
NE10026072400Medicaid
NE10026072000Medicaid
KS100411840AMedicaid
NE10026072300Medicaid
NE10026072600Medicaid
NE47070592300Medicaid
NE47070592313Medicaid
NE10026072500Medicaid
NE47070592300Medicaid
IL$$$$$$$$$Medicaid
NE274713Medicare PIN
NE47070592306Medicaid
NE47070592313Medicaid
NENA1939033Medicare PIN
NE110226367Medicare PIN