Provider Demographics
NPI:1376792036
Name:SAMEDI, VON GRAEGER (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:VON
Middle Name:GRAEGER
Last Name:SAMEDI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2211 LOMAS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2745
Mailing Address - Country:US
Mailing Address - Phone:505-272-3481
Mailing Address - Fax:505-272-2963
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:PATHOLOGY MSC 08 4640
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-3481
Practice Address - Fax:505-272-2963
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA228474207ZP0102X
NMMD2011-0539207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology