Provider Demographics
NPI:1902642507
Name:NASIM, SUMMIYA
Entity type:Individual
Prefix:
First Name:SUMMIYA
Middle Name:
Last Name:NASIM
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 1:15910 BALLANTYNE TRL
Mailing Address - Street 2:
Mailing Address - City:HUNTERTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46748
Mailing Address - Country:US
Mailing Address - Phone:260-354-9432
Mailing Address - Fax:
Practice Address - Street 1:15910 BALLANTYNE TRL
Practice Address - Street 2:
Practice Address - City:HUNTERTOWN
Practice Address - State:IN
Practice Address - Zip Code:46748
Practice Address - Country:US
Practice Address - Phone:260-354-9432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program