Basic Information
Provider Information
NPI: 1831574748
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SYEDA
FirstName: UZMA
MiddleName: NAAZ
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 21400 E 11 MILE RD
Address2:  
City: SAINT CLAIR SHORES
State: MI
PostalCode: 480811566
CountryCode: US
TelephoneNumber: 5864984422
FaxNumber: 5864984440
Practice Location
Address1: 718 MERRISH RD
Address2:  
City: TORONTO
State: ONTARIO
PostalCode: M1C 1G3
CountryCode: CA
TelephoneNumber: 4802416768
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/22/2015
LastUpdateDate: 08/07/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X4301107057MIY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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