Basic Information
| Provider Information | |||||||||
| NPI: | 1861703159 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHMAD | ||||||||
| FirstName: | ANBAR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3747 ROSWELL RD | ||||||||
| Address2: | WELLSTAR ENDOCRINOLOGY, SUITE 202 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300627974 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6784034300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3180 N POINT PKWY STE 302 | ||||||||
| Address2: | |||||||||
| City: | ALPHARETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300054381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6782248686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2010 | ||||||||
| LastUpdateDate: | 05/15/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 69748 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 202I467859 | 01 | GA | MEDICARE | OTHER |