Provider Demographics
NPI:1932112521
Name:ALSAMMAN, MAJD (MD)
Entity Type:Individual
Prefix:
First Name:MAJD
Middle Name:
Last Name:ALSAMMAN
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 1:713 E MARION AVE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-3872
Mailing Address - Country:US
Mailing Address - Phone:941-833-1750
Mailing Address - Fax:
Practice Address - Street 1:713 E MARION AVE
Practice Address - Street 2:SUITE 121
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3872
Practice Address - Country:US
Practice Address - Phone:941-833-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME775742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260237700Medicaid
FLME77574OtherLICENSE
FLME77574OtherLICENSE
58562Medicare ID - Type Unspecified
FLME77574OtherLICENSE