Provider Demographics
NPI:1720672488
Name:ANUJEH, CLEARIS (DR)
Entity Type:Individual
Prefix:DR
First Name:CLEARIS
Middle Name:
Last Name:ANUJEH
Suffix:
Gender:F
Credentials:DR
Other - Prefix:DR
Other - First Name:CLEARIS
Other - Middle Name:
Other - Last Name:ANUJEH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOCTORATE
Mailing Address - Street 1:5104 THORNTON KNOLL WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8045
Mailing Address - Country:US
Mailing Address - Phone:301-364-8835
Mailing Address - Fax:
Practice Address - Street 1:5104 THORNTON KNOLL WAY
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-8045
Practice Address - Country:US
Practice Address - Phone:301-364-8835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC006340363LP0808X
NC5017194363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00430485Medicaid
DCNONEOtherNONE