Provider Demographics
NPI:1861440380
Name:EL DAHR, SAMIR S (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:S
Last Name:EL DAHR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MOHAMMED SAMIR
Other - Middle Name:SAYEM
Other - Last Name:EL-DAHR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1430 TULANE AVE
Mailing Address - Street 2:SL-37
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-5456
Mailing Address - Fax:504-988-1771
Practice Address - Street 1:1415 TULANE AVE
Practice Address - Street 2:HC-18, 5TH FLOOR
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2600
Practice Address - Country:US
Practice Address - Phone:504-988-6253
Practice Address - Fax:504-988-7654
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.08505R2080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1901563Medicaid
LA5N166Medicare PIN
E78011Medicare UPIN