Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35079166 | OH |
N | 111NI0900X | Internist | 35079166 | OH |
N | 207R00000X | Internist | 37001 | KY |
N | 111NI0900X | Internist | 37001 | KY |
Y | 207RN0300X | Nephrologist | 35079166 | OH |
NPI | 1033158688 |
---|---|
Provider Name | Ahmad Anjak |
First Address | Cincinnati, OH 45263-6256 |
Second Address | Cincinnati, OH 45219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 30/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200497380 | (05) | IN |
2244468 | (05) | OH |
64106982 | (05) | KY |
H36787 | (02) |