Lakshitha Anbazhakan, MD
Individual provider Active NPI Internal Medicine Physician · Augusta, GA
NPI 1245073352 · NPPES record last updated Jun 17, 2024
Key facts
- NPI
- 1245073352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 16482 (GA)
- Practice address
- 1120 15TH St
Augusta, GA 30912-0004 - Phone
- (706) 721-0211
- NPI assigned
- Jun 17, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240722004179 | GA | Order and Referring Only - Internal Medicine |
1951847391 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16482 | GA | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 16482 | GA | Yes |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0004
Mailing address
209 Kitts Dr
Augusta, GA 30909-1831
Other providers in Augusta, GA
- Salim Amrani
- Samantha Leigh Amses
- Amy M Sprague MD PC
- Megan Anandappa
- John Salvatore Anastasi
- Faye Wright Anders
- Faye S Anderson-Mathis
- Alexander Bassam Anderson
- Amanda Anderson
- Amy Michelle Anderson
All providers in Augusta, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.