Provider Demographics
NPI:1497042980
Name:VAID, SAMIR (DPT)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:
Last Name:VAID
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 DURST DR
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-8210
Mailing Address - Country:US
Mailing Address - Phone:706-825-8059
Mailing Address - Fax:
Practice Address - Street 1:204 HOLIDAY RD
Practice Address - Street 2:
Practice Address - City:MC CORMICK
Practice Address - State:SC
Practice Address - Zip Code:29835-3429
Practice Address - Country:US
Practice Address - Phone:706-825-8059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010338225100000X
SC6730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist