Provider Demographics
NPI:1114682242
Name:TAWFIK, ANDREW ASHRAF ANWAR
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:ASHRAF ANWAR
Last Name:TAWFIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 YELLOW SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN LAND
Mailing Address - State:SC
Mailing Address - Zip Code:29707-2547
Mailing Address - Country:US
Mailing Address - Phone:803-504-8772
Mailing Address - Fax:
Practice Address - Street 1:2814 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2757
Practice Address - Country:US
Practice Address - Phone:864-224-3562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist