Healthcare Provider Details

I. General information

NPI: 1619329976
Provider Name (Legal Business Name): KANWAL ANWAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 LEAVY DR FL 2
BEDFORD NH
03110-4437
US

IV. Provider business mailing address

25 LEAVY DR FL 2
BEDFORD NH
03110-4437
US

V. Phone/Fax

Practice location:
  • Phone: 603-663-3134
  • Fax:
Mailing address:
  • Phone: 603-663-3134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number267225
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number267225
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number33596
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: