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MAHMOUD SAMMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-6793
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101281974
VA
2085R0202X
Diagnostic Radiology Physician
Primary
01079253A
IN
2085R0202X
Diagnostic Radiology Physician
40277
KY
2085R0204X
Vascular & Interventional Radiology Physician
40277
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000495823
ANTHEM
KY
05
200898810
IN
01
40277
LICENSE
KY
05
7100009230
KY
01
P00419856
RAILROAD MEDICARE
KY
Enumeration date
10/13/2006
Last updated
06/06/2024
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