Provider Demographics
NPI:1922252295
Name:CHARGING THUNDER, ANPO WICAHPI (MD)
Entity Type:Individual
Prefix:DR
First Name:ANPO
Middle Name:WICAHPI
Last Name:CHARGING THUNDER
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 1:807 N. ASH ST
Mailing Address - Street 2:
Mailing Address - City:GORDON
Mailing Address - State:NE
Mailing Address - Zip Code:69343-0000
Mailing Address - Country:US
Mailing Address - Phone:308-282-1442
Mailing Address - Fax:308-282-1428
Practice Address - Street 1:807 N. ASH ST
Practice Address - Street 2:
Practice Address - City:GORDON
Practice Address - State:NE
Practice Address - Zip Code:69343-0000
Practice Address - Country:US
Practice Address - Phone:308-282-1442
Practice Address - Fax:308-282-1428
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA41322207Q00000X
NE25843207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEFC 0828129OtherDEA
IAFC4218497OtherDEA