MEDICARE: SAMAH ALANANZEH I MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker	393309829	MA

General Provider Information

NPI Number	:	1013889989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMAH ALANANZEH I MD

Provider Business Mailing Address
First Line	:	13 KONDAZIAN ST
Second Line	:
City	:	WATERTOWN
State	:	MA
Zip	:	02472-2830
Country	:	US
Telephone Number	:	617-905-0567
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 KONDAZIAN ST
Second Line	:
City	:	WATERTOWN
State	:	MA
Zip	:	02472-2830
Country	:	US
Telephone Number	:	617-905-0567
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2025
Last Update Date	:	01/09/2026

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