Provider Demographics
NPI:1720073620
Name:MERHEB, HICHAM SAMIR (MD)
Entity Type:Individual
Prefix:
First Name:HICHAM
Middle Name:SAMIR
Last Name:MERHEB
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 1:151 N NOB HILL RD STE 311
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1708
Mailing Address - Country:US
Mailing Address - Phone:888-409-8006
Mailing Address - Fax:888-486-0870
Practice Address - Street 1:280 SW NATURA AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-3026
Practice Address - Country:US
Practice Address - Phone:888-409-8006
Practice Address - Fax:888-486-0870
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107470207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003030200Medicaid
FL14A7WOtherBCBS OF FLORIDA
FL003030200Medicaid