Provider Demographics
NPI:1134163405
Name:TANVEER, SEEMA (MD)
Entity type:Individual
Prefix:
First Name:SEEMA
Middle Name:
Last Name:TANVEER
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 1:1400 SOUTH DOBSON ROAD
Mailing Address - Street 2:ATTN: BMG HOSPITALIST TEAM/AMANDA GUMP
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202
Mailing Address - Country:US
Mailing Address - Phone:480-412-6788
Mailing Address - Fax:480-412-6848
Practice Address - Street 1:1400 SOUTH DOBSON ROAD
Practice Address - Street 2:ATTN: BMG HOSPITALIST TEAM/AMANDA GUMP
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202
Practice Address - Country:US
Practice Address - Phone:480-412-6788
Practice Address - Fax:480-412-6848
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-097122207P00000X
IL036097122207Q00000X
AZ45367207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097122Medicaid
IL036097122-1Medicaid
AZ667972Medicaid
IL01632460OtherBLUE SHIELD
AZ667972Medicaid
ILL92930Medicare PIN
AZZ149117Medicare PIN
G85217Medicare UPIN
ILK12426Medicare PIN
IL01632460OtherBLUE SHIELD