Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fnu Samra Mariyam

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1194517714

Fnu Samra Mariyam is an Anatomic Pathology & Clinical Pathology Physician in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2025.

Licensed in
MS
In the registry since
2025
Specialties on file
2

Practice location Address checks out

2500 N State St Dept OF Pathology
Jackson, MS 39216
Phone: (601) 984-1879
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence T-5961 (MS)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1194517714
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 20, 2025
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025

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