Provider Demographics
NPI:1144531112
Name:SAMEER B. SHAMMAS, MD, PC
Entity type:Organization
Organization Name:SAMEER B. SHAMMAS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-203-0230
Mailing Address - Street 1:10905 FORT WASHINGTON RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5843
Mailing Address - Country:US
Mailing Address - Phone:301-203-0230
Mailing Address - Fax:301-203-0482
Practice Address - Street 1:10905 FORT WASHINGTON RD
Practice Address - Street 2:SUITE 305
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5843
Practice Address - Country:US
Practice Address - Phone:301-203-0230
Practice Address - Fax:301-203-0482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B9462Medicare UPIN
175307Medicare PIN