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General NPI Number Information
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NPI Number | 1396703229
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Entity Type | Individual
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Provider Name | SADIQ H AL-SAMARRAI MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 02/26/2015
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Provider Practice Location Address
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Address Line | 201 DEFENSE HWY SUITE 100
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City | ANNAPOLIS
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State | MD
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Zip | 21401-8943
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Country | US
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Telephone | 443-481-6549
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Fax | 443-481-6515
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Provider Business Mailing Address
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Address Line | 10611 HICKORY PT
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City | COLUMBIA
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State | MD
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Zip | 21044-4069
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Country | US
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Telephone | 443-481-6549
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Fax | 443-481-6515
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 225391
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D69977
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License Number State | MD
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