Provider Demographics
NPI:1205069606
Name:JAWAIRIA, MAHREEMA
Entity type:Individual
Prefix:DR
First Name:MAHREEMA
Middle Name:
Last Name:JAWAIRIA
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 1:204 STATE RD
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-2827
Mailing Address - Country:US
Mailing Address - Phone:610-379-0443
Mailing Address - Fax:610-379-4725
Practice Address - Street 1:204 STATE RD
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-2827
Practice Address - Country:US
Practice Address - Phone:610-379-0443
Practice Address - Fax:610-379-4725
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD446822207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program