Provider Demographics
NPI:1902880560
Name:ANWAR, SAMINA (MD)
Entity Type:Individual
Prefix:
First Name:SAMINA
Middle Name:
Last Name:ANWAR
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 1:235 MILL ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6114
Mailing Address - Country:US
Mailing Address - Phone:301-739-5959
Mailing Address - Fax:301-739-2403
Practice Address - Street 1:235 MILL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6114
Practice Address - Country:US
Practice Address - Phone:301-739-5959
Practice Address - Fax:301-739-2403
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00556262084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD699267600Medicaid
MD699267600Medicaid