Provider Demographics
NPI:1003256165
Name:ARAFAT, SAMER N (OD)
Entity Type:Individual
Prefix:DR
First Name:SAMER
Middle Name:N
Last Name:ARAFAT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 SAVANNAH HWY SPC 10
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7859
Mailing Address - Country:US
Mailing Address - Phone:843-627-2020
Mailing Address - Fax:
Practice Address - Street 1:576 BOYSON RD NE STE 104
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-7363
Practice Address - Country:US
Practice Address - Phone:319-373-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IA101730152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program