Provider Demographics
NPI:1750273108
Name:LILAH, SAMIRA H
Entity type:Individual
Prefix:
First Name:SAMIRA
Middle Name:H
Last Name:LILAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12837 GRAND ELM ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4393
Mailing Address - Country:US
Mailing Address - Phone:240-821-3931
Mailing Address - Fax:
Practice Address - Street 1:12837 GRAND ELM ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-4393
Practice Address - Country:US
Practice Address - Phone:240-821-3931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRSA-02616372600000X, 163WH0200X
MDRSA-20616374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide