Healthcare Provider Details

I. General information

NPI: 1780642579
Provider Name (Legal Business Name): ANIL YAKHMI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13914 SOUTHEASTERN PKWY STE 308
FISHERS IN
46037-7126
US

IV. Provider business mailing address

11650 OLIO RD SUITE 1000-131
FISHERS IN
46037-7619
US

V. Phone/Fax

Practice location:
  • Phone: 317-415-9277
  • Fax: 317-415-9280
Mailing address:
  • Phone: 317-415-9277
  • Fax: 317-415-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number01040422A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: