Provider Demographics
NPI:1356703821
Name:GANG, ANJULIE (MD)
Entity type:Individual
Prefix:
First Name:ANJULIE
Middle Name:
Last Name:GANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:9002 N MERIDIAN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5354
Mailing Address - Country:US
Mailing Address - Phone:178-445-5303
Mailing Address - Fax:317-844-5590
Practice Address - Street 1:9002 N MERIDIAN ST STE 100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5354
Practice Address - Country:US
Practice Address - Phone:317-844-5530
Practice Address - Fax:317-844-5590
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01084019A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology