Healthcare Provider Details
I. General information
NPI: 1073549598
Provider Name (Legal Business Name): M F ANWAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2006
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
626 MAIN ST
POINT PLEASANT WV
25550-1121
US
IV. Provider business mailing address
1500 LAFAYETTE AVE
MOUNDSVILLE WV
26041-2345
US
V. Phone/Fax
- Phone: 304-675-4300
- Fax: 304-675-4306
- Phone: 304-845-0908
- Fax: 304-845-1250
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 000605 |
| License Number State | WV |
VIII. Authorized Official
Name: DR.
MOHAMMAD
FAROOQ
ANWAR
Title or Position: BILLING OFFICE
Credential: MD
Phone: 304-845-0908