MEDICARE: DR. SAMI H MOUSSA 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	207R00000X	Internal Medicine Physician	MD062259L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	110230305	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	20051993	OTHER	AMERIHEALTH MERCY
2	50063084	OTHER	CBC
3	P006221	OTHER	GATEWAY HEALTH PLAN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0478234000	OTHER	IBC
7	129943	OTHER	UNISON
8	537537	OTHER	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1386630424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMI H MOUSSA MD

Provider Business Mailing Address
First Line	:	421 W CHEW ST
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18102-3406
Country	:	US
Telephone Number	:	610-776-5100
Fax Number	:	610-663-3113

Provider Business Practice Location Address
First Line	:	2416 3RD ST
Second Line	:
City	:	WHITEHALL
State	:	PA
Zip	:	18052-4822
Country	:	US
Telephone Number	:	610-264-2188
Fax Number	:	610-264-3391

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	10/25/2007

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Directions to “ DR. SAMI H MOUSSA MD” Practice Location

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