Healthcare Provider Details

I. General information

NPI: 1467148148
Provider Name (Legal Business Name): SHERAZ ANJUM M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 WALTON WAY
AUGUSTA GA
30901-2612
US

IV. Provider business mailing address

5505 RIVERCHASE DR
FLOWERY BRANCH GA
30542-5168
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-9011
  • Fax:
Mailing address:
  • Phone: 706-722-9011
  • Fax: 706-774-5792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number110950
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: