MEDICARE: DR. ANOOP KUMAR KALIA 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	2084P0800X	Psychiatry Physician	200200711	NC

General Provider Information

NPI Number	:	1982691663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANOOP KUMAR KALIA M.D.

Provider Business Mailing Address
First Line	:	1054 X RAY DRIVE
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-4725
Country	:	US
Telephone Number	:	704-853-0054
Fax Number	:	704-853-0075

Provider Business Practice Location Address
First Line	:	1054 X RAY DR
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-7488
Country	:	US
Telephone Number	:	704-853-0054
Fax Number	:	704-853-0075

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

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	07/08/2007

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