Provider Demographics
NPI:1689293136
Name:SABZWARI, ANAM ALI (MD)
Entity Type:Individual
Prefix:
First Name:ANAM
Middle Name:ALI
Last Name:SABZWARI
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 1:300 SINGLETON RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9142
Mailing Address - Country:US
Mailing Address - Phone:843-347-8134
Mailing Address - Fax:843-347-5880
Practice Address - Street 1:300 SINGLETON RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9142
Practice Address - Country:US
Practice Address - Phone:843-347-8134
Practice Address - Fax:843-347-5880
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program