Provider Demographics
NPI:1851425060
Name:PAWAR, ANJALI (MD)
Entity Type:Individual
Prefix:MS
First Name:ANJALI
Middle Name:
Last Name:PAWAR
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 1:2516 STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2208
Mailing Address - Country:US
Mailing Address - Phone:916-734-2752
Mailing Address - Fax:916-451-3014
Practice Address - Street 1:2516 STOCKTON BLVD
Practice Address - Street 2:TICON II
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2208
Practice Address - Country:US
Practice Address - Phone:916-734-2781
Practice Address - Fax:916-451-3014
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010807452080P0207X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3501810371OtherBCBSM
MI3501810371OtherBCBSM