Basic Information
Provider Information
NPI: 1164840591
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANAND
FirstName: VIDHU
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.B.B.S
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 1ST ST SW
Address2:  
City: ROCHESTER
State: MN
PostalCode: 559050001
CountryCode: US
TelephoneNumber: 5072842511
FaxNumber:  
Practice Location
Address1: 1400 BELLINGER ST
Address2:  
City: EAU CLAIRE
State: WI
PostalCode: 547035222
CountryCode: US
TelephoneNumber: 7158383635
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/02/2014
LastUpdateDate: 06/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X61806MNN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RC0000X22566WIY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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