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NPI Code Detail

MEDICARE: DR. JOHN MICHAEL SAMOL MD

MEDICARE: DR. JOHN MICHAEL SAMOL MD
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
1207V00000XObstetrics & Gynecology Physician35083093SOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17489687OTHEROHAETNA
207-05611OTHEROHUNITED HEALTHCARE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4299932OTHEROHAMERIGROUP
5000000369006OTHEROHANTHEM

General Provider Information

NPI Number : 1558352419
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN MICHAEL SAMOL MD
Provider Business Mailing Address
First Line : 4600 WESLEY AVE
Second Line : STE. N
City : CINCINNATI
State : OH
Zip : 45212-2298
Country : US
Telephone Number : 513-841-5220
Fax Number : 513-841-1580
Provider Business Practice Location Address
First Line : 8245 NORTHCREEK DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-2283
Country : US
Telephone Number : 513-745-1706
Fax Number : 513-891-2197
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 02/25/2009

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Directions to “ DR. JOHN MICHAEL SAMOL MD” Practice Location

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