Healthcare Provider Details

I. General information

NPI: 1861051435
Provider Name (Legal Business Name): RAHEEL ANWAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2019
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N WOLFE ST APT 323
BALTIMORE MD
21231-1691
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 405-945-4741
  • Fax: 888-972-5320
Mailing address:
  • Phone: 410-933-6423
  • Fax: 410-500-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0101694
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: