Provider Demographics
NPI:1265430904
Name:BISHT-NADLER, SEEMA (MD)
Entity type:Individual
Prefix:DR
First Name:SEEMA
Middle Name:
Last Name:BISHT-NADLER
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 1:3030 MCEVER RD STE 130
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-5538
Mailing Address - Country:US
Mailing Address - Phone:678-450-0747
Mailing Address - Fax:678-450-0779
Practice Address - Street 1:3030 MCEVER RD STE 130
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-5538
Practice Address - Country:US
Practice Address - Phone:678-450-0747
Practice Address - Fax:678-450-0779
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2024-12-03
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
GA046361208000000X, 174400000X
GA246361208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52821173OtherBLUE CROSS/BLUE SHIELD
GA714506728AMedicaid