Provider Demographics
NPI:1164576369
Name:AZAR, GEORGE ANIS (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ANIS
Last Name:AZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:89 W MILLS ST
Practice Address - Street 2:STE A
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-9450
Practice Address - Country:US
Practice Address - Phone:828-894-3718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01896207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5906942Medicaid
NCP00429517OtherRAILROAD MEDICARE
NCNC5128AMedicare PIN
NC5906942Medicaid
NC2065434Medicare PIN