Provider Demographics
NPI:1972548691
Name:AKRUK, SAMIR RIZK (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:RIZK
Last Name:AKRUK
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 LANGHORNE NEWTOWN RD 304A
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1222
Mailing Address - Country:US
Mailing Address - Phone:215-750-9999
Mailing Address - Fax:215-750-9504
Practice Address - Street 1:1205 LANGHORNE NEWTOWN RD 304A
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1222
Practice Address - Country:US
Practice Address - Phone:215-750-9999
Practice Address - Fax:215-750-9504
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039759L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD039759LOtherPA LICENSE
PA1194928861OtherGROUP NPI
PA01011260Medicaid
PAAA2859380OtherDEA
PAB41739Medicare UPIN
PAAK432770Medicare ID - Type Unspecified