Provider Demographics
NPI:1780029785
Name:BHANGAV, ANISHA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANISHA
Middle Name:
Last Name:BHANGAV
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 1:420 DELAWARE ST SE # E12-125
Mailing Address - Street 2:MMC 295
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-626-6519
Mailing Address - Fax:612-624-0687
Practice Address - Street 1:420 DELAWARE ST SE # E12-125
Practice Address - Street 2:MMC 295
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0341
Practice Address - Country:US
Practice Address - Phone:612-626-6519
Practice Address - Fax:612-624-0687
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program