MEDICARE: FOUAD J SAMAHA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	78298	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043212541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FOUAD J SAMAHA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 86
Second Line	:
City	:	HINGHAM
State	:	MA
Zip	:	02043-0086
Country	:	US
Telephone Number	:	781-749-9071
Fax Number	:	781-749-2133

Provider Business Practice Location Address
First Line	:	2300 CROWN COLONY DR
Second Line	:	SUITE 101
City	:	QUINCY
State	:	MA
Zip	:	02169-0902
Country	:	US
Telephone Number	:	617-786-7600
Fax Number	:	617-786-7616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	03/30/2009

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