Individual
GEORGE R BOU SAMRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
126 E CHURCH ST STE 3100, SOMERSET, PA 15501-2274
(814) 445-7101
(814) 445-7688
Mailing address
1111 LOWRY AVE, BLDG A, JEANNETTE, PA 15644-3063
(724) 374-5920
(724) 374-5873
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD-067949-L
PA
207RI0011X
Interventional Cardiology Physician
Primary
MD-067949-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001751503
—
PA
01
—
025444
MEDICARE
PA
Enumeration date
08/29/2006
Last updated
11/20/2024
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