Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | D0069793 | MD |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | D0069793 | MD |
NPI | 1134105141 |
---|---|
Provider Name | Dr. Michael Anvari |
First Address | Bowie, MD 20716-3130 |
Second Address | Bowie, MD 20716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 22/04/2019 |