Basic Information
| Provider Information | |||||||||
| NPI: | 1992951586 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | VORA | ||||||||
| FirstName: | ANUP | ||||||||
| MiddleName: | AMIT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 CROSSROADS DR | ||||||||
| Address2: | SUITE 306 | ||||||||
| City: | OWINGS MILLS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211175421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4437382872 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3801 INTERNATIONAL DR | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209061550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015989717 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2008 | ||||||||
| LastUpdateDate: | 04/06/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 30321 | WV | N | Allopathic & Osteopathic Physicians | Urology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208800000X | D077463 | MD | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 2564033 00 | 05 | MD | MEDICAID |