Provider Demographics
NPI:1780813956
Name:SAMAHA, KEVIN EMILE (PA)
Entity type:Individual
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First Name:KEVIN
Middle Name:EMILE
Last Name:SAMAHA
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Gender:M
Credentials:PA
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Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:SHAPIRO CC2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-2140
Mailing Address - Fax:617-667-0227
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:SHAPIRO CC2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-2140
Practice Address - Fax:617-667-0227
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2013-09-30
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical