MEDICARE: ANAND NARASIMHADEVAR VENKATA M.D

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	207RP1001X	Pulmonary Disease Physician	2014042575	MO

General Provider Information

NPI Number	:	1801028824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANAND NARASIMHADEVAR VENKATA M.D

Provider Business Mailing Address
First Line	:	PO BOX 843225
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64184-3225
Country	:	US
Telephone Number	:	813-262-8160
Fax Number	:	813-891-9066

Provider Business Practice Location Address
First Line	:	24 S MOUNT AUBURN RD
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-4914
Country	:	US
Telephone Number	:	573-331-5544
Fax Number	:	573-331-5545

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

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	02/09/2016

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