Provider Demographics
NPI:1538427588
Name:SERAFI, SAM W (MD)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:W
Last Name:SERAFI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1220B E JOPPA RD STE 310
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5818
Mailing Address - Country:US
Mailing Address - Phone:410-494-1888
Mailing Address - Fax:410-494-1008
Practice Address - Street 1:1220B E JOPPA RD STE 310
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21286-5818
Practice Address - Country:US
Practice Address - Phone:410-494-1888
Practice Address - Fax:410-494-1008
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2020-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0083475207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD239802800Medicaid