Individual
DR. TSAHI SAMRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
(618) 988-6166
Mailing address
1239 E MAIN ST, CARBONDALE, IL 62901-3175
(618) 684-3156
(618) 684-1040
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036148605
IL
208M00000X
Hospitalist Physician
Primary
036148605
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214881
MEDICARE GROUP PTAN
IL
Enumeration date
06/22/2016
Last updated
01/06/2021
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