Provider Demographics
NPI:1669411104
Name:ANWAR, MOHAMMED S (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:S
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 1:281 HARTFORD TPKE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4784
Mailing Address - Country:US
Mailing Address - Phone:860-875-2444
Mailing Address - Fax:
Practice Address - Street 1:27 NAEK RD STE 2
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3965
Practice Address - Country:US
Practice Address - Phone:860-875-2444
Practice Address - Fax:860-872-2936
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034310207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001230465Medicaid
CT001343102Medicaid
CTF94027Medicare UPIN