Provider Demographics
NPI:1326489972
Name:SAMAR, ARASH (MD)
Entity Type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:SAMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 LAKELAND DR STE 1052
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4609
Mailing Address - Country:US
Mailing Address - Phone:601-981-9503
Mailing Address - Fax:601-981-7895
Practice Address - Street 1:971 LAKELAND DR STE 1052
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4609
Practice Address - Country:US
Practice Address - Phone:601-981-9503
Practice Address - Fax:601-981-7895
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS27749207RP1001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program