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General NPI Number Information
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NPI Number | 1851021034
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Entity Type | Individual
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Provider Name | SAMEER NASIR MIAN DO
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Gender | Male
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Dates
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Enumeration Date | 06/12/2022
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 300 W OAK ST
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City | CARBONDALE
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State | IL
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Zip | 62901-1400
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Country | US
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Telephone | 618-536-6621
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Fax |
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Provider Business Mailing Address
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Address Line | 603 CELANDINE TERRACE
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City | MILTON
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State | ON
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Zip | L9E 1Z7
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Country | CA
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Telephone |
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 5101028510
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License Number State | MI
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