Provider Demographics
NPI:1811071517
Name:ANWAR, ROSWITHA (MD)
Entity type:Individual
Prefix:DR
First Name:ROSWITHA
Middle Name:
Last Name:ANWAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSWITHA
Other - Middle Name:
Other - Last Name:VOLKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:216 N AZUSA AVE
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-3524
Mailing Address - Country:US
Mailing Address - Phone:626-334-7849
Mailing Address - Fax:626-969-1609
Practice Address - Street 1:216 N AZUSA AVE
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-3524
Practice Address - Country:US
Practice Address - Phone:626-334-7849
Practice Address - Fax:626-969-1609
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24789Medicare ID - Type UnspecifiedCA LICENSE