MEDICARE: DR. OMAR SYED 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	207L00000X	Anesthesiology Physician	54263	AZ
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	54263	AZ
3	208VP0000X	Pain Medicine Physician	54263	AZ

General Provider Information

NPI Number	:	1902165046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OMAR SYED M.D.

Provider Business Mailing Address
First Line	:	6320A W UNION HILLS DR STE 270
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-2151
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6320A W UNION HILLS DR STE 270
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-2151
Country	:	US
Telephone Number	:	480-561-5000
Fax Number	:

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

Provider Enumeration Date	:	05/10/2012
Last Update Date	:	07/12/2021

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