Provider Demographics
NPI:1316981517
Name:ANJUM, AFSHAN (MB BS)
Entity type:Individual
Prefix:
First Name:AFSHAN
Middle Name:
Last Name:ANJUM
Suffix:
Gender:F
Credentials:MB BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2450 RIVERSIDE AVE S
Mailing Address - Street 2:2A WEST
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1450
Mailing Address - Country:US
Mailing Address - Phone:612-273-8700
Mailing Address - Fax:612-273-8787
Practice Address - Street 1:2450 RIVERSIDE AVE S
Practice Address - Street 2:2A WEST
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-273-8700
Practice Address - Fax:612-273-8787
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN463302084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP48313OtherHEALTHPARTNERS
MN181603900Medicaid
MNC620OtherCHAMPUS/TRIWEST
IA0589853Medicaid
MN15-64903OtherMEDICA CHOICE
MN174R9ANOtherBCBS
MT0081600Medicaid
MN1042741OtherPREFERRED ONE
MN136210OtherUCARE
MN2280058OtherARAZ
MN174R9ANOtherBCBS
MNI20564Medicare UPIN