Provider Demographics
NPI:1548076326
Name:WARE, ANITA CAROL
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:CAROL
Last Name:WARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13303E.STATEFAIR ST.
Mailing Address - Street 2:13303 E STATE FAIR ST
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-1715
Mailing Address - Country:US
Mailing Address - Phone:313-556-3902
Mailing Address - Fax:
Practice Address - Street 1:13303E.STATEFAIR ST.
Practice Address - Street 2:13303 E STATE FAIR ST
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-1715
Practice Address - Country:US
Practice Address - Phone:313-556-3902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty