Provider Demographics
NPI:1457021164
Name:ANU ANTONY MD PLLC
Entity Type:Organization
Organization Name:ANU ANTONY MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANUJA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ANTONY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-704-2122
Mailing Address - Street 1:8382 SIX FORKS RD STE 102
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5080
Mailing Address - Country:US
Mailing Address - Phone:919-616-0215
Mailing Address - Fax:252-442-5056
Practice Address - Street 1:8382 SIX FORKS RD STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5080
Practice Address - Country:US
Practice Address - Phone:919-616-0215
Practice Address - Fax:252-442-5056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty