Basic Information
| Provider Information | |||||||||
| NPI: | 1427547033 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASEEM | ||||||||
| FirstName: | FAZILA | ||||||||
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| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5639 OLD CHAPEL HILL RD APT 908 | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277079777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4045362034 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 MANNING DRIVE | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199668162 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2018 | ||||||||
| LastUpdateDate: | 05/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 238460 | NC | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.