Provider Demographics
NPI:1124536479
Name:ZAINUDDIN, SAMEERA
Entity Type:Individual
Prefix:
First Name:SAMEERA
Middle Name:
Last Name:ZAINUDDIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1130
Mailing Address - Country:US
Mailing Address - Phone:334-262-6161
Mailing Address - Fax:334-834-1705
Practice Address - Street 1:1215 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1130
Practice Address - Country:US
Practice Address - Phone:334-262-6161
Practice Address - Fax:334-834-1705
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH8727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist