Individual
ANUBHA JATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
302 UNIVERSITY PKWY, AIKEN, SC 29801-6302
(803) 641-5000
Mailing address
16036 THORN WOOD DR, FORT MYERS, FL 33908-4133
(803) 641-5000
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
15268R
MS
2084N0400X
Neurology Physician
Primary
40164
SC
2084N0400X
Neurology Physician
MD.15268R
LA
2084N0400X
Neurology Physician
ME121356
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01457513
—
MS
05
—
015253500
—
FL
05
—
1196096
—
LA
05
—
PENDING
—
SC
Enumeration date
03/03/2006
Last updated
05/01/2019
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