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NPI Code Detail

MEDICARE: DR. ANDREW LEWIS SAMUELSON M.D.

MEDICARE: DR. ANDREW LEWIS SAMUELSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianP5129TX
2207RG0100XGastroenterology PhysicianP5129TX
3207RG0100XGastroenterology Physician048988CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1023816OTHERCOKAISER COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215119516
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW LEWIS SAMUELSON M.D.
Provider Business Mailing Address
First Line : 10350 E DAKOTA AVE
Second Line :
City : DENVER
State : CO
Zip : 80247-1314
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 280 EXEMPLA CIR
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-3370
Country : US
Telephone Number : 303-338-4545
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2007
Last Update Date : 12/11/2025

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