Basic Information
| Provider Information | |||||||||
| NPI: | 1346683836 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALEEM | ||||||||
| FirstName: | ASIMA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3920A BRIDGE RD | ||||||||
| Address2: | STE 207 | ||||||||
| City: | SUFFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234351107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7579832200 | ||||||||
| FaxNumber: | 7579832201 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 FAIRFAX AVE | ||||||||
| Address2: | GHENT FAMILY MEDICINE CENTER, 1ST FLOOR | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235071914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574465955 | ||||||||
| FaxNumber: | 7574465013 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2013 | ||||||||
| LastUpdateDate: | 07/25/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | NOT YET OBTAINED | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 0101259503 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.