Provider Demographics
NPI:1861481723
Name:ACHEM, SAMI RENE (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMI
Middle Name:RENE
Last Name:ACHEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMI
Other - Middle Name:RENE
Other - Last Name:ACHEM-KARAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4500 SAN PABLO RD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-1865
Mailing Address - Country:US
Mailing Address - Phone:904-953-2000
Mailing Address - Fax:
Practice Address - Street 1:4500 SAN PABLO RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-1865
Practice Address - Country:US
Practice Address - Phone:904-953-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46021207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15927OtherBLUECROSS/BLUESHIELD
FL100010705OtherRAILROAD MEDICARE
FL069560200Medicaid
FL15927YMedicare PIN
FL069560200Medicaid