MEDICARE: DR. SAMRAH H AL-SAYED M.D.

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	208000000X	Pediatrics Physician	35071703	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12-02760	OTHER	OH	UNITED HEALTH CARE
2	7579152	OTHER	OH	AETNA
3	000000064923	OTHER	OH	ANTHEM BC/BS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891791885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMRAH H AL-SAYED M.D.

Provider Business Mailing Address
First Line	:	2150 W CENTRAL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3834
Country	:	US
Telephone Number	:	419-291-5599
Fax Number	:	419-291-6466

Provider Business Practice Location Address
First Line	:	2150 W CENTRAL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3834
Country	:	US
Telephone Number	:	419-291-5599
Fax Number	:	419-291-6466

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	09/16/2013

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