Healthcare Provider Details

I. General information

NPI: 1619354180
Provider Name (Legal Business Name): GHULAM SARWAR N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2015
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 203 HEROLD TERRACE
SASKATOON SASKATCHEWAN
S7V 1H4
CA

IV. Provider business mailing address

3901 S FIFE ST STE 301
TACOMA WA
98409-7309
US

V. Phone/Fax

Practice location:
  • Phone: 306-373-3589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5376750021
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60998211
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: