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NPI Code Detail

MEDICARE: VICTORIA SAMUEL PA-C

MEDICARE: VICTORIA SAMUEL PA-C
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
1363A00000XPhysician Assistant50.007700RXOH

General Provider Information

NPI Number : 1518685601
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA SAMUEL PA-C
Provider Business Mailing Address
First Line : 248 MAIN ST APT 518
Second Line :
City : WESTLAKE
State : OH
Zip : 44145-8168
Country : US
Telephone Number : 440-591-8286
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2475
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2022
Last Update Date : 08/16/2022

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Directions to “ VICTORIA SAMUEL PA-C” Practice Location

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