Individual
ANIL KUMAR CHANGARATH VIJAYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
1200 6TH AVENUE NORTH, CENTRACARE CLINIC RIVER CAMPUS, ST CLOUD, MN 56303-2735
(320) 240-2207
(320) 240-7896
Mailing address
1200 6TH AVENUE NORTH, CENTRACARE CLINIC RIVER CAMPUS, ST CLOUD, MN 56303-2735
(320) 240-2207
(320) 240-7896
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.125622
IL
207R00000X
Internal Medicine Physician
35.121030
OH
207R00000X
Internal Medicine Physician
60177
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036.125622
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35.121030
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
60177
MN
207RP1001X
Pulmonary Disease Physician
036.125622
IL
207RP1001X
Pulmonary Disease Physician
35.121030
OH
207RP1001X
Pulmonary Disease Physician
60177
MN
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
036125622
IL
Other
Enumeration date
11/15/2007
Last updated
08/21/2025
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