Basic Information
| Provider Information | |||||||||
| NPI: | 1578660015 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAHDAL | ||||||||
| FirstName: | SAMIR | ||||||||
| MiddleName: | Y | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3709 N CAMPBELL AVE | ||||||||
| Address2: | STE 135 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857191565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208383540 | ||||||||
| FaxNumber: | 5208382348 | ||||||||
| Practice Location | |||||||||
| Address1: | 5140 E GLENN ST | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857121337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208383540 | ||||||||
| FaxNumber: | 5203253526 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2006 | ||||||||
| LastUpdateDate: | 10/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | A90652 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 35850 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.