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General NPI Number Information
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NPI Number | 1356653463
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Entity Type | Individual
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Provider Name | SUMERA YAQUB M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 3700 WASHINGTON AVE
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City | EVANSVILLE
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State | IN
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Zip | 47714-0541
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Country | US
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Telephone | 812-485-7040
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Fax | 812-485-7042
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Provider Business Mailing Address
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Address Line | 12101 WOODCREST EXECUTIVE DR STE 210
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City | SAINT LOUIS
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State | MO
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Zip | 63141-5047
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Country | US
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Telephone | 314-317-0600
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Fax | 314-317-0606
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | FY5568019
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2010014300
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License Number State | MO
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