Healthcare Provider Details

I. General information

NPI: 1083450035
Provider Name (Legal Business Name): RANA USMAN ANWAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 25TH ST
ALAMOGORDO NM
88310-8722
US

IV. Provider business mailing address

2669 SCENIC DR
ALAMOGORDO NM
88310-8799
US

V. Phone/Fax

Practice location:
  • Phone: 575-446-5815
  • Fax:
Mailing address:
  • Phone: 575-439-6100
  • Fax: 844-290-1192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRS2024-0198
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRS2024-0198
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: