Healthcare Provider Details

I. General information

NPI: 1407822927
Provider Name (Legal Business Name): ANWAR I KHOKHAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 N EUTAW ST 103
BALTIMORE MD
21201-4648
US

IV. Provider business mailing address

8621 STONEHOUSE DR
ELLICOTT CITY MD
21043-1936
US

V. Phone/Fax

Practice location:
  • Phone: 410-225-8760
  • Fax: 410-225-8456
Mailing address:
  • Phone: 410-292-6585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD32700
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: