Individual
SAMIR BHANDUTIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1200 W TABOR RD FL 4, PHILADELPHIA, PA 19141-3019
(215) 456-3815
(215) 456-6803
Mailing address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-1825
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
OS020669
PA
207P00000X
Emergency Medicine Physician
25MB10735400
NJ
208VP0014X
Interventional Pain Medicine Physician
Primary
OS020669
PA
Other
Enumeration date
06/22/2016
Last updated
09/17/2025
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