Basic Information
Provider Information
NPI: 1649745563
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DARWICH
FirstName: SAMER
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2007 PALM BEACH LAKES BLVD
Address2:  
City: WEST PALM BEACH
State: FL
PostalCode: 334096501
CountryCode: US
TelephoneNumber: 5614208555
FaxNumber: 5614208550
Practice Location
Address1: 2007 PALM BEACH LAKES BLVD
Address2:  
City: WEST PALM BEACH
State: FL
PostalCode: 334096501
CountryCode: US
TelephoneNumber: 5614208555
FaxNumber: 5614208550
Other Information
ProviderEnumerationDate: 10/07/2018
LastUpdateDate: 02/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XTL168AZN Allopathic & Osteopathic PhysiciansInternal Medicine 
207Q00000XACN1163FLY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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