Provider Demographics
NPI:1508822719
Name:SIOUFFI, SAMER Y (MD)
Entity Type:Individual
Prefix:
First Name:SAMER
Middle Name:Y
Last Name:SIOUFFI
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 1:695 E WESTERN RESERVE RD
Mailing Address - Street 2:#1804
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-4310
Mailing Address - Country:US
Mailing Address - Phone:330-965-0217
Mailing Address - Fax:
Practice Address - Street 1:1350 LOCUST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-562-3292
Practice Address - Fax:412-281-2610
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA067797L207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017873820003Medicaid
PA049340GK7Medicare ID - Type Unspecified
PAF05399Medicare UPIN