Provider Demographics
NPI:1790475945
Name:MEMDANI, ANISHA (MD)
Entity Type:Individual
Prefix:MS
First Name:ANISHA
Middle Name:
Last Name:MEMDANI
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 1:3401 NORTH BOULEVARD, SUITE 130
Mailing Address - Street 2:BRG MID CITY MEDICINE CLINIC
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806
Mailing Address - Country:US
Mailing Address - Phone:225-387-7900
Mailing Address - Fax:
Practice Address - Street 1:3401 NORTH BOULEVARD, SUITE 130
Practice Address - Street 2:BRG MID CITY MEDICINE CLINIC
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-387-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program