MEDICARE: SAMIR HALALOU

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1689538670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIR HALALOU

Provider Business Mailing Address
First Line	:	100 CAMPUS DR
Second Line	:
City	:	ELON
State	:	NC
Zip	:	27244-9423
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 HUFFMAN MILL RD
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-8700
Country	:	US
Telephone Number	:	336-538-7000
Fax Number	:

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

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “ SAMIR HALALOU ” Practice Location

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