Healthcare Provider Details

I. General information

NPI: 1225618374
Provider Name (Legal Business Name): NAZEELA SUMER TANWEER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 09/07/2025
Certification Date: 09/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 14TH ST NW
WASHINGTON DC
20009-6865
US

IV. Provider business mailing address

3020 14TH ST NW
WASHINGTON DC
20009-6865
US

V. Phone/Fax

Practice location:
  • Phone: 202-469-4699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD600004458
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101282144
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: