Provider Demographics
NPI:1538422084
Name:BAGLEY, ANJULI ROBIN (MD)
Entity type:Individual
Prefix:DR
First Name:ANJULI
Middle Name:ROBIN
Last Name:BAGLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANJULI
Other - Middle Name:ROBIN
Other - Last Name:CHERUKURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:720-848-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00605402085R0202X
WI66890-202085R0202X
VT042-00154422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology