Provider Demographics
NPI:1124087358
Name:RAHIL, ANUDEEP K (MD)
Entity type:Individual
Prefix:
First Name:ANUDEEP
Middle Name:K
Last Name:RAHIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 VILLAGE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH OAKS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-7848
Mailing Address - Country:US
Mailing Address - Phone:651-789-9800
Mailing Address - Fax:651-789-9810
Practice Address - Street 1:400 VILLAGE CENTER DR
Practice Address - Street 2:
Practice Address - City:NORTH OAKS
Practice Address - State:MN
Practice Address - Zip Code:55127-7848
Practice Address - Country:US
Practice Address - Phone:651-789-9800
Practice Address - Fax:651-789-9810
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN50109207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
041F15875Medicare ID - Type Unspecified
H81941Medicare UPIN
WI34546500Medicaid