Provider Demographics
NPI:1073549598
Name:M F ANWAR MD INC
Entity Type:Organization
Organization Name:M F ANWAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:FAROOQ
Authorized Official - Last Name:ANWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-845-0908
Mailing Address - Street 1:1500 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26041-2345
Mailing Address - Country:US
Mailing Address - Phone:304-845-0908
Mailing Address - Fax:304-845-1250
Practice Address - Street 1:626 MAIN ST
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-1121
Practice Address - Country:US
Practice Address - Phone:304-675-4300
Practice Address - Fax:304-675-4306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV000605152W00000X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0102141Medicaid
WV001709499OtherMT BC BS
WV0095227003Medicaid
C14866OtherRR MC
9270491Medicare ID - Type Unspecified
OH0102141Medicaid