MEDICARE: ANJUMAN - ARA 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	207R00000X	Internal Medicine Physician	14086R	LA

General Provider Information

NPI Number	:	1184657314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANJUMAN - ARA MD

Provider Business Mailing Address
First Line	:	200 W ESPLANADE AVE STE 312
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-2474
Country	:	US
Telephone Number	:	504-712-8872
Fax Number	:	504-712-8879

Provider Business Practice Location Address
First Line	:	200 W ESPLANADE AVE STE 312
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-2474
Country	:	US
Telephone Number	:	504-712-8872
Fax Number	:	504-712-8879

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/08/2007

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