Provider Demographics
NPI:1760633168
Name:ANAND, NYATHAPPA GUNDAPPA (MD)
Entity Type:Individual
Prefix:
First Name:NYATHAPPA
Middle Name:GUNDAPPA
Last Name:ANAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10800 PARKSIDE DR STE 330
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1926
Mailing Address - Country:US
Mailing Address - Phone:865-647-3550
Mailing Address - Fax:865-647-3559
Practice Address - Street 1:10820 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1956
Practice Address - Country:US
Practice Address - Phone:865-647-3550
Practice Address - Fax:865-647-3559
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0032252084N0400X
GA838662084N0400X
TNMD698082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03035027Medicaid
NY2115320OtherIHA
NY000530748001OtherBLUECROSS BLUESHIELD