Provider Demographics
NPI:1275288227
Name:MASIH, SAMEER KUMAR
Entity Type:Individual
Prefix:
First Name:SAMEER
Middle Name:KUMAR
Last Name:MASIH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1357 VANDERBILT RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2231
Mailing Address - Country:US
Mailing Address - Phone:678-834-2675
Mailing Address - Fax:
Practice Address - Street 1:1357 VANDERBILT RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2231
Practice Address - Country:US
Practice Address - Phone:678-834-2675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR245741363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care