Provider Demographics
NPI:1619177227
Name:MISRA, ANURUDDH KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANURUDDH
Middle Name:KUMAR
Last Name:MISRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5080 SPECTRUM DR
Mailing Address - Street 2:SUITE 1200 WEST
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:972-364-8000
Mailing Address - Fax:214-775-4502
Practice Address - Street 1:2 CONNECTICUT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-2451
Practice Address - Country:US
Practice Address - Phone:415-648-9501
Practice Address - Fax:415-621-0611
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-21
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93441207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACE787AMedicare PIN
CACN912WMedicare UPIN
CACE787FMedicare UPIN
CAZZZ07334ZMedicare PIN
CACN912YMedicare UPIN
CACN912TMedicare UPIN
CACE787GMedicare PIN
CACE787CMedicare PIN
CACN912XMedicare UPIN
CACN912RMedicare UPIN
CACN912VMedicare UPIN
CACN912SMedicare UPIN
CACE787EMedicare PIN
CACE787DMedicare PIN
CACN912UMedicare UPIN
CACE787BMedicare PIN