Provider Demographics
NPI:1508742578
Name:SYEDA, SAMEERA
Entity type:Individual
Prefix:
First Name:SAMEERA
Middle Name:
Last Name:SYEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N73W28651 BARK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-8323
Mailing Address - Country:US
Mailing Address - Phone:262-337-5316
Mailing Address - Fax:
Practice Address - Street 1:N73W28651 BARK RIVER RD
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-8323
Practice Address - Country:US
Practice Address - Phone:262-337-5316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program