Provider Demographics
NPI:1174537401
Name:ANWAR, ASGHAR MOHAMMAD (MD)
Entity type:Individual
Prefix:DR
First Name:ASGHAR
Middle Name:MOHAMMAD
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 1:74 W CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1310
Mailing Address - Country:US
Mailing Address - Phone:845-454-6174
Mailing Address - Fax:845-454-5371
Practice Address - Street 1:74 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1310
Practice Address - Country:US
Practice Address - Phone:845-454-6174
Practice Address - Fax:845-454-5371
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203858207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01923239Medicaid
8U147Medicare ID - Type Unspecified
NY01923239Medicaid