MEDICARE: USAMA SAMAAN MD

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	208000000X	Pediatrics Physician	01011255804	VA

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	:	1124316211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	USAMA SAMAAN MD

Provider Business Mailing Address
First Line	:	1770 N PARHAM RD STE 100
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4658
Country	:	US
Telephone Number	:	804-665-5457
Fax Number	:

Provider Business Practice Location Address
First Line	:	1770 N PARHAM RD STE 100
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4658
Country	:	US
Telephone Number	:	804-665-5457
Fax Number	:

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

Provider Enumeration Date	:	07/11/2011
Last Update Date	:	07/30/2022

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Directions to “ USAMA SAMAAN MD” Practice Location

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