Provider Demographics
NPI:1629025515
Name:ANAND, SANJEEV (MD)
Entity Type:Individual
Prefix:
First Name:SANJEEV
Middle Name:
Last Name:ANAND
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 1:190 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2277
Mailing Address - Country:US
Mailing Address - Phone:814-371-7590
Mailing Address - Fax:814-371-7579
Practice Address - Street 1:190 W PARK AVE
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2277
Practice Address - Country:US
Practice Address - Phone:814-371-7590
Practice Address - Fax:814-371-7579
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041102L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
169673OtherUNISON HEALTH PLAN
212223OtherUPMC HEALTH PLAN
1506108OtherGATEWAY HEALTH PLAN
4541485OtherAETNA
PA743389OtherHIGHMARK BLUE SHIELD
PA0014158140003Medicaid
212223OtherUPMC HEALTH PLAN
PA0014158140003Medicaid