Healthcare Provider Details

I. General information

NPI: 1255019840
Provider Name (Legal Business Name): UNKNOWN SUMAIYAH FATIMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3188 BELLEVUE AVE
CINCINNATI OH
45219-2369
US

IV. Provider business mailing address

UNIVERSITY OF CINCINNATI MEDICAL CENTER 231 ALBERT SABIN WAY, ML 0547 / POB 670547
CINCINNATI OH
45267-0547
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-1705
  • Fax:
Mailing address:
  • Phone: 513-558-4444
  • Fax: 513-558-8581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: