MEDICARE: ANJAN MEDICAL MANAGEMENT PLLC

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	208D00000X	General Practice Physician	2006-00122	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1881659019	OTHER		NPI

General Provider Information

NPI Number	:	1649463993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANJAN MEDICAL MANAGEMENT PLLC

Provider Business Mailing Address
First Line	:	1444 S 17TH ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-6436
Country	:	US
Telephone Number	:	910-793-4311
Fax Number	:	910-793-4322

Provider Business Practice Location Address
First Line	:	1444 S 17TH ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-6436
Country	:	US
Telephone Number	:	910-793-4311
Fax Number	:	910-793-4322

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. ANTHONY K NJAPA
Credential	:	DO,MD
Telephone Number	:	910-793-4311

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	01/03/2023

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