MEDICARE: ANIL REGMI

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	11023228A	IN

General Provider Information

NPI Number	:	1780369512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIL REGMI

Provider Business Mailing Address
First Line	:	2307 FLORIDA DR APT C9
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-3560
Country	:	US
Telephone Number	:	574-261-2403
Fax Number	:

Provider Business Practice Location Address
First Line	:	2307 FLORIDA DR APT C9
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-3560
Country	:	US
Telephone Number	:	574-261-2403
Fax Number	:

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

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	07/21/2023

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Directions to “ ANIL REGMI ” Practice Location

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