Basic Information
| Provider Information | |||||||||
| NPI: | 1184069965 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANIDI | ||||||||
| FirstName: | IFEANYICHUKWU | ||||||||
| MiddleName: | UGOCHUKWU | ||||||||
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| Credential: | M.D. PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 CENTER DRIVE | ||||||||
| Address2: | ROOM 2C145 | ||||||||
| City: | BETHESDA | ||||||||
| State: | DC | ||||||||
| PostalCode: | 208921662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014969320 | ||||||||
| FaxNumber: | 3014021213 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 SPRUCE ST | ||||||||
| Address2: | 100 CENTREX | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156622200 | ||||||||
| FaxNumber: | 2156627919 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2013 | ||||||||
| LastUpdateDate: | 06/20/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | MD460074 | DC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.