Provider Demographics
NPI:1831975366
Name:ALSAMMRAI, AHMED
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ALSAMMRAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 SAINT JOHN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2823
Mailing Address - Country:US
Mailing Address - Phone:603-633-0255
Mailing Address - Fax:
Practice Address - Street 1:435 SAINT JOHN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2823
Practice Address - Country:US
Practice Address - Phone:603-633-0255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)