Provider Demographics
NPI:1275638199
Name:ABRAKSIA, SAMIR (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:
Last Name:ABRAKSIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 SINTON PL
Mailing Address - Street 2:
Mailing Address - City:PEPPER PIKE
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4630
Mailing Address - Country:US
Mailing Address - Phone:216-595-0549
Mailing Address - Fax:
Practice Address - Street 1:4200 WARRENSVILLE CENTER RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7051
Practice Address - Country:US
Practice Address - Phone:216-491-6438
Practice Address - Fax:330-562-9417
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061538174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1347023OtherFIRST HLT
OH1974049001OtherCIGNA INS
OH900002534OtherRR MEDICARE
OH3000153OtherUNITED HLTHCARE/SO POINT
OH4649556OtherAETNA NON HMO
OH2106881OtherAETNA HMO
OH328195OtherPRIME HLTH CORP
OH0972407Medicaid
OH3000216OtherUNITED HLTHCARE/HURON
OH3000153OtherUNITED HLTHCARE/SO POINT
OHF76597Medicare UPIN
OH0763072Medicare Oscar/Certification