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General NPI Number Information
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NPI Number | 1568432797
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Entity Type | Individual
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Provider Name | GHULAM WARIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 926 SNOW HILL RD
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City | SALISBURY
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State | MD
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Zip | 21804-1939
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Country | US
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Telephone | 410-572-6264
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 RIVERPLACE BLVD SUITE 620
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City | JACKSONVILLE
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State | FL
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Zip | 32207-9046
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Country | US
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Telephone | 904-396-6620
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Fax | 904-396-6528
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | D0058410
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License Number State | MD
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