Provider Demographics
NPI:1063261287
Name:PATHAK, SAMI MILAN (MD)
Entity type:Individual
Prefix:DR
First Name:SAMI
Middle Name:MILAN
Last Name:PATHAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3401 N BROAD ST STE C540
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-5103
Mailing Address - Country:US
Mailing Address - Phone:215-707-7200
Mailing Address - Fax:215-707-3831
Practice Address - Street 1:3401 N BROAD ST STE C540
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-707-7200
Practice Address - Fax:215-707-3831
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT231503207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery