Healthcare Provider Details

I. General information

NPI: 1275553638
Provider Name (Legal Business Name): TAIMUR ANWAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 W WARREN AVE
DETROIT MI
48210-1134
US

IV. Provider business mailing address

6550 W WARREN AVE
DETROIT MI
48210-1134
US

V. Phone/Fax

Practice location:
  • Phone: 313-897-7700
  • Fax: 313-897-5991
Mailing address:
  • Phone: 313-897-7700
  • Fax: 313-897-5991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301077003
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: