Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | MD417997 | PA |
N | 207RH0002X | Hospice and Palliative Medicine | MD417997 | PA |
Y | 207RP1001X | Pulmonary Disease | MD417997 | PA |
NPI | 1346299922 |
---|---|
Provider Name | Samer Alkhuja |
First Address | East Stroudsburg, PA 18301-3006 |
Second Address | East Stroudsburg, PA 18301-3098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 16/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018834780001 | (05) | PA |
AL1334930 | BCBS (01) | PA |
G71704 | (02) | PA |