| Mohammad K Anwar MD, LLC | |
|
4113 Williams Blvd Kenner LA 70065 | |
| (316) 461-7843 | |
| (504) 754-7713 |
| Full Name | Mohammad K Anwar MD, LLC |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4113 Williams Blvd, Kenner, Louisiana |
| Authorized Official Name and Position | Mohammad Anwar (OWNER) |
| Authorized Official Contact | 3164617843 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammad K Anwar MD, LLC 212 Legrande Bayou Lane Kenner LA 70065 Ph: (316) 461-7843 | Mohammad K Anwar MD, LLC 4113 Williams Blvd Kenner LA 70065 Ph: (316) 461-7843 |
| NPI Number | 1124698048 |
|---|---|
| Provider Enumeration Date | 07/01/2021 |
| Last Update Date | 07/09/2021 |
| Certification Date | 07/09/2021 |
| Medicare PECOS PAC ID | 8426451238 |
|---|---|
| Medicare Enrollment ID | O20210730000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124698048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | () | Primary |
| Provider Name | Brealon M Lirette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710400833 PECOS PAC ID: 8820363153 Enrollment ID: I20171012000093 |
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