Provider Demographics
NPI:1487273017
Name:ANUM, TOOBA (MD)
Entity type:Individual
Prefix:
First Name:TOOBA
Middle Name:
Last Name:ANUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 TAHOE DR
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4105
Mailing Address - Country:US
Mailing Address - Phone:920-750-2825
Mailing Address - Fax:
Practice Address - Street 1:5354 REYNOLDS ST STE 424
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6011
Practice Address - Country:US
Practice Address - Phone:912-819-5999
Practice Address - Fax:912-819-5980
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA96368208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty