Provider Demographics
NPI:1316957921
Name:JEHA, SIMA (MD)
Entity type:Individual
Prefix:DR
First Name:SIMA
Middle Name:
Last Name:JEHA
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 1:262 DANNY THOMAS PL
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-3678
Mailing Address - Country:US
Mailing Address - Phone:901-595-3006
Mailing Address - Fax:901-595-3842
Practice Address - Street 1:262 DANNY THOMAS PL
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-3678
Practice Address - Country:US
Practice Address - Phone:901-595-3006
Practice Address - Fax:901-595-3842
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN379202080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0149532Medicaid
AR152670001Medicaid
IL405817963-1Medicaid
IN200476920AMedicaid
MO208416107Medicaid
KY64085293Medicaid
AR99603OtherAR BCBS
OK200026860AMedicaid
AL009951815Medicaid
IA0585257Medicaid
ME422400000Medicaid
NC7614119Medicaid
MS08674723Medicaid
LA1069230Medicaid
VA1316957921Medicaid
TN28011OtherTLC
TN4072667OtherBCBST
MS08674723Medicaid
ME422400000Medicaid
LA1069230Medicaid
MO208416107Medicaid