Provider Demographics
NPI:1831531995
Name:KOHEN, ANIQA A (MD)
Entity type:Individual
Prefix:
First Name:ANIQA
Middle Name:A
Last Name:KOHEN
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 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10101 ERNST RD STE 1400
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:IN
Practice Address - Zip Code:46783-9711
Practice Address - Country:US
Practice Address - Phone:260-234-5400
Practice Address - Fax:317-222-2372
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01093064A207R00000X, 207RG0100X
TN71788207R00000X, 207RG0100X
VA0101282848207R00000X, 207RG0100X
SC75636207RG0100X
NY285200207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300096561Medicaid
IN1104324324OtherANTHEM PTAN