Provider Demographics
NPI:1356640171
Name:MOHANDES, SAMER (MD)
Entity type:Individual
Prefix:
First Name:SAMER
Middle Name:
Last Name:MOHANDES
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 1:3400 SPRUCE STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4228
Mailing Address - Country:US
Mailing Address - Phone:937-367-5373
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4228
Practice Address - Country:US
Practice Address - Phone:215-662-2638
Practice Address - Fax:215-662-2638
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD476950207R00000X, 207RN0300X
OH35123101207RN0300X
IN01084173A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology