Provider Demographics
NPI:1972690444
Name:ANEJA, ARJUN D (MD)
Entity Type:Individual
Prefix:
First Name:ARJUN
Middle Name:D
Last Name:ANEJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:325 CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8178
Mailing Address - Country:US
Mailing Address - Phone:386-672-6356
Mailing Address - Fax:386-672-6366
Practice Address - Street 1:325 CLYDE MORRIS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8178
Practice Address - Country:US
Practice Address - Phone:386-672-6356
Practice Address - Fax:386-672-6366
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME66169174400000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2670748OtherAETNA HMO
7927305OtherAETNA PPO
27847OtherBCBSFL
144681CBOtherPREFFERED CARE
FL262303000Medicaid
F54916Medicare UPIN
FL262303000Medicaid