Provider Demographics
NPI:1336341692
Name:ANWAR, AMBER (MD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ANWAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:850 W RIO SALADO PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3812
Mailing Address - Country:US
Mailing Address - Phone:480-480-8330
Mailing Address - Fax:480-610-6189
Practice Address - Street 1:4710 N HABANA AVE STE 107
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7143
Practice Address - Country:US
Practice Address - Phone:813-910-0030
Practice Address - Fax:813-348-6223
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.122767207R00000X, 207RG0300X, 208M00000X
FLME138987207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL118535900Medicaid
IL036122767Medicaid
MO1336341692Medicaid