Provider Demographics
NPI:1710913389
Name:SEN, ANANYA B (MD)
Entity Type:Individual
Prefix:
First Name:ANANYA
Middle Name:B
Last Name:SEN
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:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-3300
Mailing Address - Fax:701-364-8906
Practice Address - Street 1:2527 LYONS STATION ROAD
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522
Practice Address - Country:US
Practice Address - Phone:919-528-1535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND8619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDHP38542OtherHEALTHPARTNERS #
ND0107745OtherMEDICA #
ND0113947OtherMEDICA #
ND11710Medicaid
ND142062OtherUCARE #
ND594119900Medicaid
ND21274OtherNDBS #
ND49G07SEOtherMNBS #
ND0108165OtherMEDICA #
NC5904139Medicaid
ND0108575OtherMEDICA #
NDND100058OtherLHS #
ND1280720OtherAMERICA'S PPO/ARAZ #
ND49G08SEOtherMNBS #
NDDA9011029736OtherPREFERRED ONE #
NDND100058OtherLHS #
ND0108165OtherMEDICA #
ND49G07SEOtherMNBS #
ND21274Medicare ID - Type UnspecifiedND MEDICARE #