Provider Demographics
NPI:1346439254
Name:MANRAL, ANJU (MD)
Entity type:Individual
Prefix:
First Name:ANJU
Middle Name:
Last Name:MANRAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANJU
Other - Middle Name:
Other - Last Name:JAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-5361
Mailing Address - Fax:
Practice Address - Street 1:8100 CONSTITUTION PL NE STE 400
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7644
Practice Address - Country:US
Practice Address - Phone:505-559-1122
Practice Address - Fax:505-559-6067
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2007-0736207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine