Basic Information
| Provider Information | |||||||||
| NPI: | 1851646285 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANTHONY ANUNWA MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 N LORRAINE ST | ||||||||
| Address2: | |||||||||
| City: | HUTCHINSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 675015670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206637595 | ||||||||
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| Address1: | 1600 N LORRAINE ST | ||||||||
| Address2: | |||||||||
| City: | HUTCHINSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 675015670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206637595 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2012 | ||||||||
| LastUpdateDate: | 07/23/2012 | ||||||||
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| AuthorizedOfficialLastName: | FITCH | ||||||||
| AuthorizedOfficialFirstName: | JUDY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALS COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 9138517780 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | 0800288 | KS | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 0800288 | 01 | KS | LICESNE | OTHER |