Organization
SAM F WANIS DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMEH FAYEZ WANIS D.O. (PHYSICIAN)
(561) 969-3500
Entity
Organization
Contact information
Practice address
2925 10TH AVE N, SUITE #204, LAKE WORTH, FL 33460-3046
(561) 969-3500
(561) 966-8898
Mailing address
2925 10TH AVE N, SUITE #204, LAKE WORTH, FL 33460-3046
(561) 969-3500
(561) 966-8898
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
OS7511
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253706100
—
FL
Enumeration date
12/23/2008
Last updated
02/04/2009
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