Basic Information
| Provider Information | |||||||||
| NPI: | 1477725109 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAMAAN | ||||||||
| FirstName: | MUHANNAD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21465 DETROIT ROAD | ||||||||
| Address2: | APT A105 | ||||||||
| City: | ROCKY RIVER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441162222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4406557808 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2600 SIXTH STREET SW | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447101702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303632180 | ||||||||
| FaxNumber: | 3303632179 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2008 | ||||||||
| LastUpdateDate: | 04/02/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 90950 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.