Provider Demographics
NPI:1356720072
Name:TANDON, ANAMIKA (MD)
Entity type:Individual
Prefix:DR
First Name:ANAMIKA
Middle Name:
Last Name:TANDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANAMIKA
Other - Middle Name:
Other - Last Name:GARG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1026 A AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5074
Mailing Address - Country:US
Mailing Address - Phone:319-368-5970
Mailing Address - Fax:316-368-5973
Practice Address - Street 1:2900 MEDICAL CENTER PKWY STE 240A
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3204
Practice Address - Country:US
Practice Address - Phone:479-553-2700
Practice Address - Fax:479-553-1972
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-44705208M00000X
ARE-14308207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE-14308OtherSTATE MEDICAL LICENSE