Provider Demographics
NPI:1528286275
Name:PARSIA, SAM STANFORD (MD)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:STANFORD
Last Name:PARSIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:67 SKILLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-2208
Mailing Address - Country:US
Mailing Address - Phone:212-263-6479
Mailing Address - Fax:
Practice Address - Street 1:3210 POWDER MILL RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-1029
Practice Address - Country:US
Practice Address - Phone:301-937-3939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215480207RC0200X
NYD0079882207RP1001X
MDD0079882207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH35102Medicare UPIN