Provider Demographics
NPI:1114287141
Name:AFSARI, SEEMA AGGARWAL (DO)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:AGGARWAL
Last Name:AFSARI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SEEMA
Other - Middle Name:A
Other - Last Name:AGGARWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:136 N MAIN ST
Mailing Address - Street 2:STE 201
Mailing Address - City:THIENSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53092-1606
Mailing Address - Country:US
Mailing Address - Phone:262-242-3369
Mailing Address - Fax:833-505-2315
Practice Address - Street 1:136 N MAIN ST
Practice Address - Street 2:STE 201
Practice Address - City:THIENSVILLE
Practice Address - State:WI
Practice Address - Zip Code:53092-1606
Practice Address - Country:US
Practice Address - Phone:262-242-3369
Practice Address - Fax:833-505-2315
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine