Basic Information
| Provider Information | |||||||||
| NPI: | 1710913389 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEN | ||||||||
| FirstName: | ANANYA | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6001 | ||||||||
| Address2: | |||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 581086001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013643300 | ||||||||
| FaxNumber: | 7013648906 | ||||||||
| Practice Location | |||||||||
| Address1: | 2527 LYONS STATION ROAD | ||||||||
| Address2: | |||||||||
| City: | CREEDMOOR | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9195281535 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2006 | ||||||||
| LastUpdateDate: | 10/12/2007 | ||||||||
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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 | 207Q00000X | 8619 | ND | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | HP38542 | 01 | ND | HEALTHPARTNERS # | OTHER | 0107745 | 01 | ND | MEDICA # | OTHER | 0113947 | 01 | ND | MEDICA # | OTHER | 11710 | 05 | ND | MEDICAID | 142062 | 01 | ND | UCARE # | OTHER | 594119900 | 05 | ND | MEDICAID | 21274 | 01 | ND | NDBS # | OTHER | 49G07SE | 01 | ND | MNBS # | OTHER | 0108165 | 01 | ND | MEDICA # | OTHER | 5904139 | 05 | NC | MEDICAID | 0108575 | 01 | ND | MEDICA # | OTHER | ND100058 | 01 | ND | LHS # | OTHER | 1280720 | 01 | ND | AMERICA'S PPO/ARAZ # | OTHER | 49G08SE | 01 | ND | MNBS # | OTHER | DA9011029736 | 01 | ND | PREFERRED ONE # | OTHER |