Provider Demographics
NPI:1659350866
Name:VOORA, SAM R (MD)
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:R
Last Name:VOORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:153 E 13TH ST STE 1300
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16503-1035
Mailing Address - Country:US
Mailing Address - Phone:814-452-5853
Mailing Address - Fax:814-452-5583
Practice Address - Street 1:232 W 25TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16544-2665
Practice Address - Country:US
Practice Address - Phone:814-452-5853
Practice Address - Fax:814-452-5583
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD030372E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009323530004Medicaid
PA443367OtherHIGHMARK
PACO3683Medicare UPIN