Provider Demographics
NPI:1811429178
Name:ANANDARAJ, ANTONY ANANDARAJ (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONY ANANDARAJ
Middle Name:
Last Name:ANANDARAJ
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 1:202 10TH ST SE STE 225
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2419
Mailing Address - Country:US
Mailing Address - Phone:319-364-7101
Mailing Address - Fax:319-363-1993
Practice Address - Street 1:202 10TH ST SE STE 225
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2419
Practice Address - Country:US
Practice Address - Phone:319-364-7101
Practice Address - Fax:319-363-1993
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-47457207RI0011X
IA47457207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology