Healthcare Provider Details

I. General information

NPI: 1699961250
Provider Name (Legal Business Name): SAMIR ISSA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7180 HIGHLAND DR
PITTSBURGH PA
15206-1206
US

IV. Provider business mailing address

7180 HIGHLAND DR
PITTSBURGH PA
15206-1206
US

V. Phone/Fax

Practice location:
  • Phone: 412-688-6155
  • Fax:
Mailing address:
  • Phone: 412-688-6155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD058262L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: