Healthcare Provider Details

I. General information

NPI: 1750796587
Provider Name (Legal Business Name): SAM SKARIAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SAM SKARIAH MD

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 SCHOENERSVILLE RD STE 300
BETHLEHEM PA
18017-7300
US

IV. Provider business mailing address

1200 OLD YORK RD
ABINGTON PA
19001-3720
US

V. Phone/Fax

Practice location:
  • Phone: 484-884-5733
  • Fax:
Mailing address:
  • Phone: 215-481-2191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD461283
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD461283
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: