Provider Demographics
NPI:1457790602
Name:SYED, NIDA JAVED (MD)
Entity type:Individual
Prefix:MISS
First Name:NIDA
Middle Name:JAVED
Last Name:SYED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3105 S SARE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-0052
Mailing Address - Country:US
Mailing Address - Phone:812-994-0918
Mailing Address - Fax:317-296-7187
Practice Address - Street 1:3105 S SARE RD STE 400
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-0052
Practice Address - Country:US
Practice Address - Phone:812-994-0918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43015040442084P0800X
IN01079324B2084P0800X
FLME1518122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry