Provider Demographics
NPI:1528209434
Name:ANWARUL HAQ, MD, PC
Entity Type:Organization
Organization Name:ANWARUL HAQ, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANWARUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-995-5756
Mailing Address - Street 1:605 N FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-2902
Mailing Address - Country:US
Mailing Address - Phone:605-995-5756
Mailing Address - Fax:605-995-5750
Practice Address - Street 1:605 N FOSTER ST
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-2902
Practice Address - Country:US
Practice Address - Phone:605-995-5756
Practice Address - Fax:605-995-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4229261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0005012OtherBLUE SHIELD
SD6630060Medicaid
SD6630060Medicaid
1272640001Medicare NSC