Provider Demographics
NPI:1932518123
Name:ANWARULISLAM, SYED
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:ANWARULISLAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11995 SINGLETREE LN STE 500
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5349
Mailing Address - Country:US
Mailing Address - Phone:952-595-1301
Mailing Address - Fax:612-294-4903
Practice Address - Street 1:ADVANCED RADIOLOGY SOLUTIONS
Practice Address - Street 2:2605 SHORE ROAD, SUITE 101
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2136
Practice Address - Country:US
Practice Address - Phone:732-429-4199
Practice Address - Fax:305-718-0657
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC830982085R0202X
TXS78372085R0202X
IADO-055942085R0202X
VA01022061512085R0202X
OH34.0137012085R0202X
VT032.01339162085R0202X
NH206992085R0202X
AZ0084792085R0202X
NJ25MB108398002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology