Provider Demographics
NPI:1780642579
Name:YAKHMI, ANIL (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:
Last Name:YAKHMI
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 1:11650 OLIO RD
Mailing Address - Street 2:SUITE 1000-131
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7619
Mailing Address - Country:US
Mailing Address - Phone:317-415-9277
Mailing Address - Fax:317-415-9280
Practice Address - Street 1:13914 SOUTHEASTERN PKWY STE 308
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7126
Practice Address - Country:US
Practice Address - Phone:317-415-9277
Practice Address - Fax:317-415-9280
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ01040422A207RG0100X
IN01040422A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100061640DMedicaid
IN100061640BMedicaid
IN100061640BMedicaid