Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 0101236368 | VA |
NPI | 1063417707 |
---|---|
Provider Name | Shaker George Saman |
First Address | Norfolk, VA 23502-1866 |
Second Address | Norfolk, VA 23502-1866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 14/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010227852 | (05) | VA |
1412X | BCBS OF NORTH CAROLINA (01) | NC |
5902625 | (05) | NC |
74882 | OPTIMA (01) | VA |
G65901 | (02) | VA |
P00291601 | RAILROAD MEDICARE (01) | VA |