Healthcare Provider Details
I. General information
NPI: 1235351172
Provider Name (Legal Business Name): SUMIYA MAJEED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/02/2007
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13914 SOUTHEASTERN PKWY STE 314
FISHERS IN
46037-7130
US
IV. Provider business mailing address
11109 PARKVIEW PLAZA DR # 17
FORT WAYNE IN
46845-1701
US
V. Phone/Fax
- Phone: 317-872-1415
- Fax: 317-773-5945
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 01083238A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: