Provider Demographics
NPI:1811878150
Name:CHEHREH, SAMIRA (PA-C)
Entity type:Individual
Prefix:
First Name:SAMIRA
Middle Name:
Last Name:CHEHREH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8922 LIBERTY RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:NOKESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20181-3245
Mailing Address - Country:US
Mailing Address - Phone:703-606-1095
Mailing Address - Fax:
Practice Address - Street 1:630 E RIVER ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5902
Practice Address - Country:US
Practice Address - Phone:703-329-7500
Practice Address - Fax:440-329-7507
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1236919363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical