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NPI Code Detail

MEDICARE: DR. ABDUL-BADI ABOU-SAMRA M.D., PH.D.

MEDICARE: DR. ABDUL-BADI ABOU-SAMRA M.D., PH.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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician35.154884OH
2207RE0101XEndocrinology, Diabetes & Metabolism Physician4301089157MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1724182OTHERMATUFTS
28327117-001OTHERMACIGNA PAL #'S
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
458956OTHERMALICENSE NUMBER
55904607OTHERMAAETNA:
6E80629042MGHOTHERMAHPHC- PBO
7UNITED-PBOOTHERMA3304179
8E80629MGHOTHERMAHPHC-ACD

General Provider Information

NPI Number : 1932195203
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ABDUL-BADI ABOU-SAMRA M.D., PH.D.
Provider Business Mailing Address
First Line : 3000 ARLINGTON AVE STOP 1108
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2595
Country : US
Telephone Number : 419-383-5322
Fax Number :
Provider Business Practice Location Address
First Line : 2100 W CENTRAL AVE STE 200
Second Line :
City : TOLEDO
State : OH
Zip : 43606-3817
Country : US
Telephone Number : 567-420-1600
Fax Number : 567-420-1633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 01/07/2026

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