Healthcare Provider Details

I. General information

NPI: 1851683395
Provider Name (Legal Business Name): ANWAAR AHMED KHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date: 10/23/2025
Reactivation Date: 11/19/2025

III. Provider practice location address

4420 LAKE BOONE TRL
RALEIGH NC
27607-7505
US

IV. Provider business mailing address

5221 PARAMOUNT PKWY STE 220
MORRISVILLE NC
27560-5490
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-5050
  • Fax: 919-784-1487
Mailing address:
  • Phone: 984-215-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101272034
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number24082
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number24082
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: