Provider Demographics
NPI:1568049864
Name:ABOHAMAD, SAMAR ALI MOHAMED
Entity Type:Individual
Prefix:
First Name:SAMAR
Middle Name:ALI MOHAMED
Last Name:ABOHAMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21595
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4112
Mailing Address - Country:US
Mailing Address - Phone:251-300-5941
Mailing Address - Fax:
Practice Address - Street 1:6304 USA HEALTH BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-0020
Practice Address - Country:US
Practice Address - Phone:251-633-8880
Practice Address - Fax:251-633-2817
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2023-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL.5411R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine