Healthcare Provider Details

I. General information

NPI: 1730574542
Provider Name (Legal Business Name): ANJALIKA GANDHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5308 HARROUN RD # 285
SYLVANIA OH
43560-2193
US

IV. Provider business mailing address

100 MADISON AVE
TOLEDO OH
43604-1516
US

V. Phone/Fax

Practice location:
  • Phone: 419-824-5633
  • Fax: 419-824-5953
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number34680
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number35.145773
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: