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NPI Code Detail

MEDICARE: FAROUQ A SAMHOURI M.D

MEDICARE:   FAROUQ A SAMHOURI  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
12086S0129XVascular Surgery PhysicianMD040435EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11619524OTHERPABLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356372932
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAROUQ A SAMHOURI M.D
Provider Business Mailing Address
First Line : 1394 TANGLEWOOD DR
Second Line :
City : NORTH WALES
State : PA
Zip : 19454-3677
Country : US
Telephone Number : 215-699-8199
Fax Number :
Provider Business Practice Location Address
First Line : 2137 WELSH RD
Second Line : SUITE 1-C
City : PHILADELPHIA
State : PA
Zip : 19115-4963
Country : US
Telephone Number : 215-969-3944
Fax Number : 215-969-3886
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 07/08/2007

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