Provider Demographics
NPI:1801534383
Name:RANGAN, ANVITHA (MD)
Entity type:Individual
Prefix:MS
First Name:ANVITHA
Middle Name:
Last Name:RANGAN
Suffix:
Gender:F
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:APT 303, 50 CROSSING DRIVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864
Mailing Address - Country:US
Mailing Address - Phone:401-787-1096
Mailing Address - Fax:401-767-1674
Practice Address - Street 1:115 CASS AVENUE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895
Practice Address - Country:US
Practice Address - Phone:401-769-4100
Practice Address - Fax:401-767-1674
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2023-03-07
Deactivation Date:2023-02-22
Deactivation Code:
Reactivation Date:2023-03-07
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program