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Individual

ANSHU BAIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
430 S PARK AVE, BUFFALO, NY 14204-2618
(716) 847-6610
(716) 854-3052
Mailing address
430 S PARK AVE, BUFFALO, NY 14204-2618
(716) 847-6610
(716) 854-3052

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
261454
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
261454
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00027324401
UNIVERA
NY
01
000528279001
BLUE CROSS
NY
05
02686395
NY
01
0412972
INDEPENDENT HEALTH
NY
01
051105000027
FIDELIS
NY
01
161070314
NOVA
NY
Enumeration date
08/29/2006
Last updated
05/19/2016
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