Individual
ANITA ELANGOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1909 214TH ST SE STE 300, BOTHELL, WA 98021-4418
(425) 412-7200
Mailing address
PO BOX 7068, PORTSMOUTH, VA 23707-0068
(757) 686-3520
(757) 686-0230
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101238955
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188990
ANTHEM
VA
01
—
541951145004
TRICARE
VA
Enumeration date
02/21/2006
Last updated
05/18/2021
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