Provider Demographics
NPI:1710996855
Name:CHEEMA, PAVITAR SINGH (MD)
Entity Type:Individual
Prefix:
First Name:PAVITAR
Middle Name:SINGH
Last Name:CHEEMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38023 MEDICAL CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33540-1384
Mailing Address - Country:US
Mailing Address - Phone:813-788-7641
Mailing Address - Fax:813-782-1980
Practice Address - Street 1:38023 MEDICAL CENTER AVE
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33540
Practice Address - Country:US
Practice Address - Phone:813-788-7641
Practice Address - Fax:813-782-1980
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38130208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067139800Medicaid
FL067139800Medicaid
51183Medicare ID - Type Unspecified