MEDICARE: ANJAN GHOSH MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1477720639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANJAN GHOSH MD PA

Provider Business Mailing Address
First Line	:	15710 NW 10TH ST
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-1604
Country	:	US
Telephone Number	:	305-819-7770
Fax Number	:	305-819-8898

Provider Business Practice Location Address
First Line	:	456 W 51ST PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3620
Country	:	US
Telephone Number	:	305-819-7770
Fax Number	:	305-819-8898

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANJAN KUMAR GHOSH
Credential	:	MD
Telephone Number	:	305-819-7770

Provider Enumeration Date	:	05/15/2008
Last Update Date	:	05/15/2008

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