Provider Demographics
NPI:1205110335
Name:ANTON, SAMEH
Entity type:Individual
Prefix:
First Name:SAMEH
Middle Name:
Last Name:ANTON
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 1:101 ORCHARD DR
Mailing Address - Street 2:FRANKLIN PLAZA SHOPPING CENTER
Mailing Address - City:TRAFFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15085-1640
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 ORCHARD DR
Practice Address - Street 2:FRANKLIN PLAZA SHOPPING CENTER
Practice Address - City:TRAFFORD
Practice Address - State:PA
Practice Address - Zip Code:15085-1640
Practice Address - Country:US
Practice Address - Phone:412-856-7332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT199451207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine