Provider Demographics
NPI:1124236328
Name:SEEMA ANJUM MD LTD
Entity type:Organization
Organization Name:SEEMA ANJUM MD LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANJUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-733-9230
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-19
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8795207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCC2979OtherANTHEM
NV002018080Medicaid
NVCC2979OtherANTHEM