Provider Demographics
NPI:1376863274
Name:DAMLE, ANEEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANEEL
Middle Name:
Last Name:DAMLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3433 BROADWAY ST NE STE 115
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-1759
Mailing Address - Country:US
Mailing Address - Phone:651-312-1505
Mailing Address - Fax:612-248-2944
Practice Address - Street 1:1983 SLOAN PL STE 11
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-2004
Practice Address - Country:US
Practice Address - Phone:651-312-1620
Practice Address - Fax:651-312-1570
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018031091208600000X, 208C00000X
MN66219208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery