MEDICARE: SAMER M BASHITI D.O.

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	207P00000X	Emergency Medicine Physician	3111	WI
2	207P00000X	Emergency Medicine Physician	OT012698	PA
3	207P00000X	Emergency Medicine Physician	036.128119	IL

General Provider Information

NPI Number	:	1770744831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMER M BASHITI D.O.

Provider Business Mailing Address
First Line	:	886 N 26TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-1821
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	886 N 26TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-1821
Country	:	US
Telephone Number	:	267-761-9620
Fax Number	:

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

Provider Enumeration Date	:	06/21/2008
Last Update Date	:	02/27/2025

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Directions to “ SAMER M BASHITI D.O.” Practice Location

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