Provider Demographics
NPI:1477547958
Name:SAKLA, SAMY F (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMY
Middle Name:F
Last Name:SAKLA
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 1:2000 EOFF ST
Mailing Address - Street 2:5TH FLOOR, EAST BUILDING
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3823
Mailing Address - Country:US
Mailing Address - Phone:304-234-8161
Mailing Address - Fax:304-234-8171
Practice Address - Street 1:2000 EOFF ST
Practice Address - Street 2:5TH FLOOR, EAST BUILDING
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3823
Practice Address - Country:US
Practice Address - Phone:304-234-8161
Practice Address - Fax:304-234-8171
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15920208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0058784000Medicaid
OH0783531Medicaid
OH0783531Medicaid
WV0058784000Medicaid