MEDICARE: AANISH PURI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	36060	MN

General Provider Information

NPI Number	:	1053118216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AANISH PURI MD

Provider Business Mailing Address
First Line	:	420 DELAWARE ST SE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55455-0341
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 DELAWARE ST SE STE 1
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55455-0374
Country	:	US
Telephone Number	:	612-626-2935
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	06/22/2026

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