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General NPI Number Information
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NPI Number | 1972500288
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Entity Type | Individual
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Provider Name | ANITA KADIKAR MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 12/07/2024
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Provider Practice Location Address
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Address Line | 98 POPLAR ST
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City | BLACKFOOT
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State | ID
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Zip | 83221-1758
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Country | US
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Telephone | 208-785-4100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 51437
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City | PHOENIX
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State | AZ
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Zip | 85076-1437
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Country | US
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Telephone | 480-759-1027
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Fax | 480-759-1031
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 32085
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 32085
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License Number State | AZ
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