Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0207X | Pediatric Hematology-Oncologist | 01064575A | IN |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD-42427 | IA |
NPI | 1194945691 |
---|---|
Provider Name | Anjali A Sharathkumar |
First Address | Iowa City, IA 52242-1011 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 05/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200888810 | (05) | IN |