Provider Demographics
NPI:1316084130
Name:AGHENTA, ANTHONY ASUELIMEN (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ASUELIMEN
Last Name:AGHENTA
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 1:1434 W ELLIOT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5157
Mailing Address - Country:US
Mailing Address - Phone:480-935-8855
Mailing Address - Fax:855-450-1054
Practice Address - Street 1:1434 W ELLIOT RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5157
Practice Address - Country:US
Practice Address - Phone:480-935-8855
Practice Address - Fax:855-450-1054
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41309207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine