Provider Demographics
NPI:1275553638
Name:ANWAR, TAIMUR (MD)
Entity Type:Individual
Prefix:
First Name:TAIMUR
Middle Name:
Last Name:ANWAR
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 1:6550 W WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48210-1134
Mailing Address - Country:US
Mailing Address - Phone:313-897-7700
Mailing Address - Fax:313-897-5991
Practice Address - Street 1:6550 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48210-1134
Practice Address - Country:US
Practice Address - Phone:313-897-7700
Practice Address - Fax:313-897-5991
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077003207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4583976Medicaid
MITA077003OtherBCBS OF MICHIGAN
MIH85818Medicare UPIN
MI4583976Medicaid