Basic Information
| Provider Information | |||||||||
| NPI: | 1124415344 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANWAR | ||||||||
| FirstName: | SHAZ | ||||||||
| MiddleName: | SHUJA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24419 MILLSTREAM DR | ||||||||
| Address2: | |||||||||
| City: | ALDIE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201055837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7039571800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2366 OAK VALLEY DR | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481038944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8772278823 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2015 | ||||||||
| LastUpdateDate: | 10/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0002X | 01022040703 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 207RH0002X | 5101027060 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
No ID Information.