Healthcare Provider Details

I. General information

NPI: 1083694954
Provider Name (Legal Business Name): ANUP KUMAR LAHIRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4561 THORNBURY CLOSE WAY
FLOWERY BRANCH GA
30542-3749
US

IV. Provider business mailing address

224 W EXCHANGE ST STE 160
AKRON OH
44302-1705
US

V. Phone/Fax

Practice location:
  • Phone: 770-287-8350
  • Fax:
Mailing address:
  • Phone: 330-344-6505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number045527
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35C.001386
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number045527
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number3478
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: