Provider Demographics
NPI:1215902796
Name:DHAR, ANITHA S (MD)
Entity type:Individual
Prefix:DR
First Name:ANITHA
Middle Name:S
Last Name:DHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 ROCK SPRINGS ROAD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6804
Mailing Address - Country:US
Mailing Address - Phone:615-625-7777
Mailing Address - Fax:615-625-7700
Practice Address - Street 1:1702 ROCK SPRINGS ROAD
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-3716
Practice Address - Country:US
Practice Address - Phone:615-625-7777
Practice Address - Fax:615-625-7700
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30453207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38374321Medicaid
TN38374321Medicare PIN
TN38374321Medicaid