Healthcare Provider Details

I. General information

NPI: 1164919437
Provider Name (Legal Business Name): UMAR CHEEMA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2018
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 UNSER BLVD SE
ALBUQUERQUE NM
87124-3392
US

IV. Provider business mailing address

1606 LYRIA RD NW
ALBUQUERQUE NM
87114-4132
US

V. Phone/Fax

Practice location:
  • Phone: 505-253-7878
  • Fax:
Mailing address:
  • Phone: 505-321-8887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2023-1164
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: