Provider Demographics
NPI:1144304536
Name:SAMAHA, SIMON
Entity type:Individual
Prefix:
First Name:SIMON
Middle Name:
Last Name:SAMAHA
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 1:3 COOPER PLZ RM 502
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ONE COOPER PLAZA /HOSPITALIST TEAM
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64475207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0462239000OtherAMERIHEALTH, HMO, KEYSTONE, IBC
P418267OtherOXFORD HEALTH PLAN
1069691OtherHORIZON NJ HEALTH
1134777OtherCIGNA
16309OtherUNIVERSITY HEALTH CARE
83891OtherAMERICAID
CA0000220 00OtherAMERICHOICE
1445253OtherUNITED HEALTH CARE
702206OtherAMERIHEALTH PPO
83891OtherAMERIGROUP
3K6196OtherHEALTHNET
595238OtherAETNA
NJ7068701Medicaid
CA0000220 00OtherAMERICHOICE
1445253OtherUNITED HEALTH CARE
1134777OtherCIGNA