Individual
TAHA ANWAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3319 SPRING ST, DAVENPORT, IA 52807-2125
(563) 359-1641
(563) 359-4634
Mailing address
1 HOSPITAL DR, MC404, COLUMBIA, MO 65212-1000
(573) 884-2000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2016019975
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016019975
MISSOURI BOARD OF HEALING ARTS
MO
Enumeration date
06/16/2016
Last updated
05/02/2022
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