Provider Demographics
NPI:1407824790
Name:ANAND, MIRIAM K (MD)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:K
Last Name:ANAND
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 1:1006 E GUADALUPE RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3047
Mailing Address - Country:US
Mailing Address - Phone:480-838-4296
Mailing Address - Fax:480-820-1275
Practice Address - Street 1:1006 E GUADALUPE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3047
Practice Address - Country:US
Practice Address - Phone:480-838-4296
Practice Address - Fax:480-820-1275
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27835207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ492075Medicaid
AZ492075Medicaid
AZZ73554Medicare PIN