Provider Demographics
NPI:1063442994
Name:ACHAEN, ANIL (MD)
Entity type:Individual
Prefix:
First Name:ANIL
Middle Name:
Last Name:ACHAEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:714 N SENATE AVE STE 120
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-3297
Practice Address - Country:US
Practice Address - Phone:317-963-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01065532A207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000680371OtherANTHEM PROVIDER NUMBER FOR ARNETT
IN000000669195OtherANTHEM PROVIDER NUMBER
INQ00114548OtherRAILROAD PTAN
IN200932570Medicaid
IN000000680371OtherANTHEM PROVIDER NUMBER FOR ARNETT
INQ00114548OtherRAILROAD PTAN
INP00871838Medicare PIN
IN000000669195OtherANTHEM PROVIDER NUMBER
IN200932570Medicaid