Provider Demographics
NPI:1063404291
Name:SHAMMAS, SAMEER B (MD)
Entity type:Individual
Prefix:DR
First Name:SAMEER
Middle Name:B
Last Name:SHAMMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10905 FORT WASHINGTON RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5843
Mailing Address - Country:US
Mailing Address - Phone:301-203-0230
Mailing Address - Fax:301-203-0482
Practice Address - Street 1:10905 FORT WASHINGTON RD
Practice Address - Street 2:SUITE 305
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5843
Practice Address - Country:US
Practice Address - Phone:301-203-0230
Practice Address - Fax:301-203-0482
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0024138207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MH231683OtherMAMSI
MHOSO1SBOtherBCBS MD
MD0711OtherBCBS
MD0711OtherBCBS
MH231683OtherMAMSI