Provider Demographics
NPI:1750345559
Name:SALAMA, SAMIR A (MD)
Entity type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:A
Last Name:SALAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:800 KALISTE SALOOM RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-4210
Mailing Address - Country:US
Mailing Address - Phone:337-233-2400
Mailing Address - Fax:337-232-3656
Practice Address - Street 1:800 KALISTE SALOOM RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4210
Practice Address - Country:US
Practice Address - Phone:337-233-2400
Practice Address - Fax:337-232-3656
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08423R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1929719Medicaid
LAE50636Medicare UPIN
LA1929719Medicaid