Individual
TAHIRA SAIFUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
360 BROADWAY STE 100, BANGOR, ME 04401-3985
(207) 907-3550
(207) 907-3562
Mailing address
11035 W SYCAMORE HILLS DR STE 1, FORT WAYNE, IN 46814-9310
(260) 241-1233
(260) 373-9740
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01061185A
IN
207RG0100X
Gastroenterology Physician
MD23200
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000382926
ANTHEM
IN
01
—
000000672226
ANTHEM
IN
05
—
200800540
—
IN
05
—
2649567
—
OH
01
—
P00286425
RAILROAD
—
01
—
P00878854
MEDICARE RR
IN
Enumeration date
03/01/2006
Last updated
10/02/2024
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