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General NPI Number Information
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NPI Number | 1457790602
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Entity Type | Individual
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Provider Name | NIDA JAVED SYED M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 3105 S SARE RD STE 400
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City | BLOOMINGTON
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State | IN
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Zip | 47401-0052
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Country | US
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Telephone | 812-994-0918
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Fax |
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Provider Business Mailing Address
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Address Line | 3105 S SARE RD STE 400
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City | BLOOMINGTON
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State | IN
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Zip | 47401-0052
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Country | US
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Telephone | 812-994-0918
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Fax | 317-296-7187
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301504044
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01079324B
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME151812
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License Number State | FL
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