Provider Demographics
NPI:1629065842
Name:ANJUM, SEEMA (MD)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:
Last Name:ANJUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3599 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3344
Mailing Address - Country:US
Mailing Address - Phone:702-733-9230
Mailing Address - Fax:702-733-9243
Practice Address - Street 1:3599 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3344
Practice Address - Country:US
Practice Address - Phone:702-733-9230
Practice Address - Fax:702-733-9243
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8795207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018080Medicaid
NVCC2979OtherBLUE CROSS BLUE SHIELD
NVCC2979OtherBLUE CROSS BLUE SHIELD
NVV38567Medicare PIN