Healthcare Provider Details

I. General information

NPI: 1952375537
Provider Name (Legal Business Name): SAMEH Z. LAMIY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 08/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 SAINT SEBASTIAN WAY STE 311
AUGUSTA GA
30901-2653
US

IV. Provider business mailing address

2723 S 7TH ST SUITE A
TERRE HAUTE IN
47802-3558
US

V. Phone/Fax

Practice location:
  • Phone: 706-724-3473
  • Fax: 706-724-3493
Mailing address:
  • Phone: 812-238-1730
  • Fax: 812-242-1565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number01057852A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number01057852A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: