Provider Demographics
NPI:1578623088
Name:ANOUS, MAHER M (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHER
Middle Name:M
Last Name:ANOUS
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 1:5726 LAKE WASHINGTON BLVD NE
Mailing Address - Street 2:S-1
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7425
Mailing Address - Country:US
Mailing Address - Phone:425-576-8120
Mailing Address - Fax:425-576-8126
Practice Address - Street 1:10117 NE 58TH ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033
Practice Address - Country:US
Practice Address - Phone:425-576-8120
Practice Address - Fax:425-576-8126
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021511174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAB20919Medicare UPIN