Healthcare Provider Details

I. General information

NPI: 1861440380
Provider Name (Legal Business Name): SAMIR S EL DAHR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MOHAMMED SAMIR SAYEM EL-DAHR MD

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 01/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE HC-18, 5TH FLOOR
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1430 TULANE AVE SL-37
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-6253
  • Fax: 504-988-7654
Mailing address:
  • Phone: 504-988-5456
  • Fax: 504-988-1771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberMD.08505R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: