Provider Demographics
NPI:1073715181
Name:SHAMIMI-NOORI, SAUM A (MD)
Entity Type:Individual
Prefix:
First Name:SAUM
Middle Name:A
Last Name:SHAMIMI-NOORI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SAUM
Other - Middle Name:A
Other - Last Name:NOORI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:33 E CHESTNUT HILL AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-2713
Mailing Address - Country:US
Mailing Address - Phone:215-248-1350
Mailing Address - Fax:
Practice Address - Street 1:33 E CHESTNUT HILL AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2713
Practice Address - Country:US
Practice Address - Phone:215-248-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD442031207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease