Healthcare Provider Details

I. General information

NPI: 1689293136
Provider Name (Legal Business Name): ANAM ALI SABZWARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SINGLETON RIDGE ROAD
CONWAY SC
29526-9142
US

IV. Provider business mailing address

300 SINGLETON RIDGE ROAD
CONWAY SC
29526-9142
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-8134
  • Fax: 843-347-5880
Mailing address:
  • Phone: 843-347-8134
  • Fax: 843-347-5880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number33613
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: