Provider Demographics
NPI:1639356025
Name:ANTHONY, JAMES PRAVEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PRAVEEN
Last Name:ANTHONY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 GLENDALE BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3767
Mailing Address - Country:US
Mailing Address - Phone:219-464-9054
Mailing Address - Fax:219-465-1749
Practice Address - Street 1:1101 GLENDALE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3767
Practice Address - Country:US
Practice Address - Phone:219-464-9054
Practice Address - Fax:219-465-1749
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2020-09-10
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Provider Licenses
StateLicense IDTaxonomies
IL036.125048207R00000X, 207RC0200X, 207RP1001X
IN01071016A207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine