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NPI Code Detail

MEDICARE: SAMAR SHAHID DO

MEDICARE: SAMAR SHAHID DO
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
1207R00000XInternal Medicine PhysicianOS23842FL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1841994092
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMAR SHAHID DO
Provider Business Mailing Address
First Line : PO BOX 103204
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-0001
Country : US
Telephone Number : 352-265-0651
Fax Number : 352-265-0153
Provider Business Practice Location Address
First Line : 201 E SAMPLE RD
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33064-3502
Country : US
Telephone Number : 954-876-2790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2023
Last Update Date : 06/03/2026

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