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General NPI Number Information
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NPI Number | 1730491507
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Entity Type | Individual
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Provider Name | ANIRBAN GANGULI MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 110 IRVING ST NW 2A 70
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City | WASHINGTON
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State | DC
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Zip | 20010-3017
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Country | US
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Telephone | 240-706-2176
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Fax |
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Provider Business Mailing Address
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Address Line | 110 IRVING ST NW 2A 70
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City | WASHINGTON
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State | DC
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Zip | 20010-3017
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Country | US
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Telephone | 240-706-2176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD043421
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License Number State | DC
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