Provider Demographics
NPI:1154632305
Name:FADL, SAMER MURAD (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMER
Middle Name:MURAD
Last Name:FADL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:75 REMITTANCE DR DEPT 8310
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-8310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:565 COAL VALLEY RD
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3703
Practice Address - Country:US
Practice Address - Phone:412-230-8200
Practice Address - Fax:412-202-8638
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4613252085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty