Provider Demographics
NPI:1568642080
Name:SAMIR R. NEIMAT MD PA
Entity Type:Organization
Organization Name:SAMIR R. NEIMAT MD PA
Other - Org Name:THE VEIN CLINIC OF WASHINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEIMAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-270-8346
Mailing Address - Street 1:5454 WISCONSIN AVE STE 1040
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6915
Mailing Address - Country:US
Mailing Address - Phone:301-270-8346
Mailing Address - Fax:301-907-9221
Practice Address - Street 1:5454 WISCONSIN AVE
Practice Address - Street 2:SUITE 1040
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6901
Practice Address - Country:US
Practice Address - Phone:301-270-8346
Practice Address - Fax:301-907-9221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00185512086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC3083OtherBSBS/DC GROUP
MD339131100Medicaid
MD6384SROtherBCBS/MD GROUP
DC075791Medicare PIN
MD339131100Medicaid