Individual
DR. MURTUZA ANSARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1340 PARK ST, ORANGEBURG, SC 29115-4880
(803) 534-2507
Mailing address
1340 PARK ST, ORANGEBURG, SC 29115-4880
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
SC3819
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01326192
UNITED CONCORDIA ID
SC
01
—
BCBSAL 880-146
BCBS OF ALABAMA
SC
05
—
ZX3819
—
SC
Enumeration date
04/28/2006
Last updated
03/01/2011
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