Provider Demographics
NPI:1578543047
Name:ZEAYTER, SAMER A (MD)
Entity Type:Individual
Prefix:
First Name:SAMER
Middle Name:A
Last Name:ZEAYTER
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:PO BOX 601643
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1643
Mailing Address - Country:US
Mailing Address - Phone:704-355-0720
Mailing Address - Fax:704-355-5948
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:CMC ANNEX 1ST FLOOR
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:704-355-0720
Practice Address - Fax:704-355-5948
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA064312207RN0300X
NC2012-01882207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1578543047Medicaid
SCNC1957Medicaid
MI4782862Medicaid
MI1578543047Medicaid
MICA2184OtherRAILROAD MEDICAER
GA907331534Medicaid
NCNCB480GMedicare PIN
MI4782862Medicaid
GA202I395069Medicare PIN
NC1578543047Medicaid
MI0C97618100Medicare PIN
NCNCB480FMedicare PIN
NCNCB480IMedicare PIN