Provider Demographics
NPI:1710211669
Name:AKHTAR, SYED SUMAIR (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:SUMAIR
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 PARK PLAZA DRIVE
Mailing Address - Street 2:STE 150, MS 7110
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:562-977-4639
Mailing Address - Fax:562-741-4479
Practice Address - Street 1:401 HARDING ST NE # 100
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-2801
Practice Address - Country:US
Practice Address - Phone:612-398-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ69985207R00000X
LA339352207R00000X
MTMEDPHYSCOMLIC-131954207R00000X
CODR.0061161207R00000X
IAMD-51734207R00000X
KS04-47965207R00000X
ND20551207R00000X
ALMD.46073207R00000X
CT51915207R00000X
IN01088671207R00000X
FLME126818207R00000X
NV15806207R00000X
MN69799207R00000X
MI4301101853207R00000X
IL036-137974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine