Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 01076321A | IN |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 01076321A | IN |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | TMP-02496 | WV |
NPI | 1255541835 |
---|---|
Provider Name | Anil Purohit |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 14/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201345640 | (05) | IN |
P01678741 | MEDICARE RAILROAD PTAN (01) | IN |