Healthcare Provider Details

I. General information

NPI: 1093030827
Provider Name (Legal Business Name): ANIL H. JHANGIANI MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2010
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4172 INDIAN RIPPLE RD SUITE B
DAYTON OH
45440-3285
US

IV. Provider business mailing address

2246 ANNANDALE PL
XENIA OH
45385-9123
US

V. Phone/Fax

Practice location:
  • Phone: 937-623-9078
  • Fax: 937-376-9075
Mailing address:
  • Phone: 937-623-9078
  • Fax: 937-376-9075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ANIL H JHANGIANI
Title or Position: OWNER
Credential: M.D.
Phone: 937-623-9078