Individual
FAWWAD ALAM ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1270 PRINCE AVE, SUITE 201, ATHENS, GA 30606
(706) 475-7055
Mailing address
1330 PAGE DR S STE 101, FARGO, ND 58103-3551
(701) 526-4898
(701) 205-4734
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
10/07/2022
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