Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Annaliesa Fanguy, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1760365530

Annaliesa Fanguy, MD is a Family Practice in Mishawaka, Indiana. Graduated from Louisiana State University School of Medicine in Shreveport in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Louisiana.

Years since qualifying
1
Trained at
Louisiana State University School of Medicine in Shreveport
Licensed in
LA
In the registry since
2025
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Mishawaka, IN

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence 348260 (LA)

Record details

NPI number1760365530
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 29, 2025
Last updated in NPPESJune 2, 2026
Certification dateJune 2, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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