Provider Demographics
NPI:1417904657
Name:LELEY, ANJALI SURESH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:SURESH
Last Name:LELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1481 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-988-1772
Mailing Address - Fax:317-988-5523
Practice Address - Street 1:550 PITT ROAD
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112
Practice Address - Country:US
Practice Address - Phone:317-988-1772
Practice Address - Fax:317-988-5523
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010541501207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200444450Medicaid
IN264420VVVMedicare ID - Type Unspecified