MEDICARE: SAMINA MUNEERUDDIN 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	2080P0210X	Pediatric Nephrology Physician	C1-0013383	DE
2	2080P0210X	Pediatric Nephrology Physician	TP776	KY
3	2080P0210X	Pediatric Nephrology Physician	MD61229543	WA
4	2080P0210X	Pediatric Nephrology Physician	MD442866	PA
5	2080P0210X	Pediatric Nephrology Physician	25MA10702600	NJ

General Provider Information

NPI Number	:	1821299934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMINA MUNEERUDDIN MD

Provider Business Mailing Address
First Line	:	2661 HUNTIGDON PIKE
Second Line	:	CARRIAGE HOUSE 2ND FLOOR
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006
Country	:	US
Telephone Number	:	646-644-3219
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 S LIMESTONE K201
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0001
Country	:	US
Telephone Number	:	859-323-6211
Fax Number	:

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	01/12/2026

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