MEDICARE: SAMREEN AZEEM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	200601349	NC

General Provider Information

NPI Number	:	1093823874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMREEN AZEEM M.D.

Provider Business Mailing Address
First Line	:	5233 SUNSET LAKE RD
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-3793
Country	:	US
Telephone Number	:	919-387-8885
Fax Number	:	919-387-8861

Provider Business Practice Location Address
First Line	:	5233 SUNSET LAKE RD
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-3793
Country	:	US
Telephone Number	:	919-387-8885
Fax Number	:	919-387-8861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	01/13/2011

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