Provider Demographics
NPI:1740015940
Name:WARIS, ANUM (DR)
Entity type:Individual
Prefix:
First Name:ANUM
Middle Name:
Last Name:WARIS
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PAYSON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01607-1191
Mailing Address - Country:US
Mailing Address - Phone:508-502-8475
Mailing Address - Fax:
Practice Address - Street 1:197 BOSTON TPKE # 9
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-2545
Practice Address - Country:US
Practice Address - Phone:508-502-8475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH240213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist