Healthcare Provider Details

I. General information

NPI: 1982804555
Provider Name (Legal Business Name): SAMER A FAHMY M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 07/07/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEADOWS RD
BOCA RATON FL
33486-2304
US

IV. Provider business mailing address

8904 STARHAVEN CV
BOYNTON BEACH FL
33473-7841
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-4546
  • Fax:
Mailing address:
  • Phone: 561-459-9405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME100036
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: