Provider Demographics
NPI:1801534383
Name:RANGAN, ANVITHA (MD)
Entity type:Individual
Prefix:MS
First Name:ANVITHA
Middle Name:
Last Name:RANGAN
Suffix:
Gender:F
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:TUFTS MEDICAL CENTER
Mailing Address - Street 2:800 WASHINGTON ST, BOX 391
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-636-2240
Mailing Address - Fax:
Practice Address - Street 1:TUFTS MEDICAL CENTER
Practice Address - Street 2:800 WASHINGTON ST, BOX 391
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-2240
Practice Address - Fax:617-636-8329
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2025-07-02
Deactivation Date:2023-02-22
Deactivation Code:
Reactivation Date:2023-03-07
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA3017413207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program