Provider Demographics
NPI:1912196197
Name:PATHAK, ANAND (MD/PHD)
Entity Type:Individual
Prefix:DR
First Name:ANAND
Middle Name:
Last Name:PATHAK
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2264 S BELVOIR BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3314
Mailing Address - Country:US
Mailing Address - Phone:513-313-8620
Mailing Address - Fax:
Practice Address - Street 1:2264 S BELVOIR BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-3314
Practice Address - Country:US
Practice Address - Phone:513-313-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.013059207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine