Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 005549 | GA |
NPI | 1013272152 |
---|---|
Provider Name | Dr. Anuj Pankaj Jani |
First Address | Augusta, GA 30912-0004 |
Second Address | Augusta, GA 30912-0004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2012 |
Last Update Date | 04/07/2012 |