MEDICARE: SAMINA ZAREEN NADVI 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	208000000X	Pediatrics Physician	E-2205	AR

General Provider Information

NPI Number	:	1386695674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMINA ZAREEN NADVI M.D.

Provider Business Mailing Address
First Line	:	6801 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4067
Country	:	US
Telephone Number	:	479-274-3500
Fax Number	:	479-274-3599

Provider Business Practice Location Address
First Line	:	6801 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4067
Country	:	US
Telephone Number	:	479-274-3500
Fax Number	:	479-274-3599

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	11/11/2021

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