Provider Demographics
NPI:1154538148
Name:TANDAR, ANWAR (MD)
Entity type:Individual
Prefix:DR
First Name:ANWAR
Middle Name:
Last Name:TANDAR
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 1:30 N 1900 E
Mailing Address - Street 2:UNIVERSITY OF UTAH HOSPITAL
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0002
Mailing Address - Country:US
Mailing Address - Phone:801-585-3362
Mailing Address - Fax:801-581-7735
Practice Address - Street 1:30 N 1900 E
Practice Address - Street 2:UNIVERSITY OF UTAH HOSPITAL
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0002
Practice Address - Country:US
Practice Address - Phone:801-585-3362
Practice Address - Fax:801-581-7735
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5221728-1205207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000530313001OtherBC/BS OF WNY
NYRB8243Medicare PIN