Healthcare Provider Details

I. General information

NPI: 1801103643
Provider Name (Legal Business Name): SYED SAMEER NASIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7945 WOLF RIVER BLVD
GERMANTOWN TN
38138-1762
US

IV. Provider business mailing address

7714 POPLAR AVE., SUITE 200 ATTN: CREDENTIALING
GERMANTOWN TN
38138-3941
US

V. Phone/Fax

Practice location:
  • Phone: 901-683-0055
  • Fax: 901-685-2969
Mailing address:
  • Phone: 901-683-0055
  • Fax: 901-922-6722

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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number24958
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number55735
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: