Provider Demographics
NPI:1619189800
Name:KOHLI, ANITA (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:KOHLI
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 1:2201 W FAIRVIEW ST STE 9
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4711
Mailing Address - Country:US
Mailing Address - Phone:480-470-4000
Mailing Address - Fax:480-686-8875
Practice Address - Street 1:2201 W FAIRVIEW ST STE 9
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4711
Practice Address - Country:US
Practice Address - Phone:480-470-4000
Practice Address - Fax:480-686-8875
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49951207RI0008X, 207RI0200X
DCMD040965207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology