Basic Information
| Provider Information | |||||||||
| NPI: | 1518152495 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DASS | ||||||||
| FirstName: | ANURITA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4731 WATERS AVE | ||||||||
| Address2: | ATTENTION: SEBRENA HOLMES GIBSON | ||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314046219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123501316 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4700 WATERS AVE | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123501316 | ||||||||
| FaxNumber: | 9123502156 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2007 | ||||||||
| LastUpdateDate: | 09/04/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 065649 | GA | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 065649 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 003108106A | 05 | GA | MEDICAID | 01469484 | 01 | AMERIGROUP | OTHER | 593784 | 01 | GA | WELLCARE | OTHER | GA1176 | 05 | SC | MEDICAID | P00933361 | 01 | GA | RAILROAD MEDICARE | OTHER |