Provider Demographics
NPI:1932167467
Name:MAURYA, ANAR DESAI (OD)
Entity Type:Individual
Prefix:DR
First Name:ANAR
Middle Name:DESAI
Last Name:MAURYA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANAR
Other - Middle Name:K
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:5901C PEACHTREE DUNWOODY ROAD
Mailing Address - Street 2:STE 370
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:678-781-7373
Mailing Address - Fax:678-538-1972
Practice Address - Street 1:6105 PEACHTREE DUNWOODY RD STE A100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5911
Practice Address - Country:US
Practice Address - Phone:703-947-4000
Practice Address - Fax:709-130-8417
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002193152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA799592337EMedicaid
GA799592337FMedicaid
GA799592337DMedicaid
GA799592337CMedicaid
GA799592337EMedicaid