Basic Information
| Provider Information | |||||||||
| NPI: | 1851734834 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SYED | ||||||||
| FirstName: | UMER | ||||||||
| MiddleName: | MAHMOOD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | C/O ST MARY'S HEALTH SYSTEM - PROVIDER ENROLLMENT | ||||||||
| Address2: | PO BOX 7291 | ||||||||
| City: | LEWISTON | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042437291 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077778695 | ||||||||
| FaxNumber: | 2077778800 | ||||||||
| Practice Location | |||||||||
| Address1: | 168 KINSLEY ST | ||||||||
| Address2: | |||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030603634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035789363 | ||||||||
| FaxNumber: | 6035789539 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2013 | ||||||||
| LastUpdateDate: | 11/17/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 20597 | NH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 3123235 | 05 | NH | MEDICAID |