Provider Demographics
NPI:1962616409
Name:CHOPRA, ANISH (MD)
Entity type:Individual
Prefix:DR
First Name:ANISH
Middle Name:
Last Name:CHOPRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 KELLE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-8708
Mailing Address - Country:US
Mailing Address - Phone:219-364-3616
Mailing Address - Fax:219-364-3610
Practice Address - Street 1:85 E US HIGHWAY 6 STE 210
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8954
Practice Address - Country:US
Practice Address - Phone:219-464-9507
Practice Address - Fax:219-477-4690
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.091296207RG0100X
IN01081627A207RG0100X
KY52221207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP01774125OtherRAILROAD MEDICARE - MHCPI
WV3810027735Medicaid
OH2904209Medicaid
OHP01774125OtherRAILROAD MEDICARE - MHCPI
OHH382701Medicare PIN