MEDICARE: SAMER S OBRI 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	35079420	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7744282	OTHER	OH	AETNA
2	000000195120	OTHER	OH	ANTHEM
3	110224866	OTHER	OH	RRMC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	03962	OTHER	OH	PHC
6	04-06926	OTHER	OH	UHC

General Provider Information

NPI Number	:	1700879657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMER S OBRI MD

Provider Business Mailing Address
First Line	:	1250 RALSTON AVE
Second Line	:	SUITE 202
City	:	DEFIANCE
State	:	OH
Zip	:	43512-5311
Country	:	US
Telephone Number	:	419-784-2776
Fax Number	:	419-782-6899

Provider Business Practice Location Address
First Line	:	1250 RALSTON AVE
Second Line	:	SUITE 202
City	:	DEFIANCE
State	:	OH
Zip	:	43512-5311
Country	:	US
Telephone Number	:	419-784-2776
Fax Number	:	419-782-6899

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	11/03/2023

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Directions to “ SAMER S OBRI MD” Practice Location

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