Healthcare Provider Details

I. General information

NPI: 1720368871
Provider Name (Legal Business Name): ANWAR MERCHANT DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SUMTER STREET DEPARTMENT OF EPIDEMIOLOGY AND BIOSTATISTICS
COLUMBIA SC
29208
US

IV. Provider business mailing address

313 CABIN DR
IRMO SC
29063-7859
US

V. Phone/Fax

Practice location:
  • Phone: 803-777-6095
  • Fax:
Mailing address:
  • Phone: 803-661-6081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: