Provider Demographics
NPI:1528012408
Name:ANNE, NIRUPAMA (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:NIRUPAMA
Middle Name:
Last Name:ANNE
Suffix:
Gender:F
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:607-798-5954
Practice Address - Street 1:2 MEDICAL PARK RD STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6839
Practice Address - Country:US
Practice Address - Phone:803-434-8800
Practice Address - Fax:803-434-0492
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047010208600000X, 2086X0206X
NY238858208600000X, 2086X0206X
SC886812086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT047010OtherCONNECTICARE
CT06-1406459OtherPIONEER
CT06-1406459OtherTRICARE
CT7966939OtherAETNA
CT06-1406459OtherNORTHEAST HEALTH DIRECT
CT44721OtherHEALTH NEW ENGLAND
CT06-1406459OtherUNITED HEALTHCARE
CT010047010CT01OtherANTHEM BCBS
NY02770854Medicaid
CT06-1406459OtherPRIVATE HEALTHCARE SYSTEMS
CT06-1406459OtherGREAT WEST HEALTHCARE
CT3V1366OtherHEALTH NET
CTP3936800OtherOXFORD
CT0303481OtherCIGNA
CT06-1406459OtherWELLCARE
CT06-1406459OtherMULTIPLAN
CT06-1406459OtherCOMMUNITY HEALTH NETWORK
CT1528012408Medicaid
CT0303481OtherCIGNA
NYJ400021475Medicare PIN