Provider Demographics
NPI:1144320128
Name:TANWIR, ANJUM (MD)
Entity type:Individual
Prefix:DR
First Name:ANJUM
Middle Name:
Last Name:TANWIR
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 1:1620 US HIGHWAY 22E
Mailing Address - Street 2:SUITE 102
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3414
Mailing Address - Country:US
Mailing Address - Phone:908-451-3544
Mailing Address - Fax:201-244-3289
Practice Address - Street 1:1620 US HIGHWAY 22E
Practice Address - Street 2:SUITE 102
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3414
Practice Address - Country:US
Practice Address - Phone:908-451-3544
Practice Address - Fax:201-244-3289
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08116700207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ91002822900OtherAMERICHOICE
NJ0120383Medicaid
NJP00855694OtherRAILROAD MEDICARE
NJ91002822900OtherAMERICHOICE
NJ107263UXWMedicare PIN
NJ107263ZD3TMedicare PIN
NJ107263SNYMedicare PIN