Provider Demographics
NPI:1649331752
Name:MORE, ANUJ VINEET (MD)
Entity type:Individual
Prefix:DR
First Name:ANUJ
Middle Name:VINEET
Last Name:MORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 7TH STREET RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-4103
Mailing Address - Country:US
Mailing Address - Phone:502-883-6800
Mailing Address - Fax:502-384-2316
Practice Address - Street 1:3939 7TH STREET RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-4103
Practice Address - Country:US
Practice Address - Phone:502-883-6800
Practice Address - Fax:502-384-2316
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45579207R00000X
NY242098207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK107912OtherKY MEDICARE
IN201225730Medicaid
KY7100257830Medicaid
KYP01843124-KOHMGOtherRR MEDICARE
NYRB3903Medicare PIN
IN201225730Medicaid
KY7100257830Medicaid