Individual
JOHN J. ANAGNOSTOU JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-3634
Mailing address
250 W 96TH ST # 520, INDIANAPOLIS, IN 46260-1316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02005211A
IN
208M00000X
Hospitalist Physician
02005211A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001117365
ANTHEM PROVIDER NUMBER
IN
05
—
300006963
—
IN
Enumeration date
03/28/2014
Last updated
09/18/2018
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