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NPI Code Detail

MEDICARE: SUZANNE J SAMPANG M.D.

MEDICARE: SUZANNE J SAMPANG 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
12084P0804XChild & Adolescent Psychiatry Physician35078999OH

General Provider Information

NPI Number : 1821017286
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE J SAMPANG M.D.
Provider Business Mailing Address
First Line : 3333 BURNET AVE
Second Line : ML 6015
City : CINCINNATI
State : OH
Zip : 45229-3039
Country : US
Telephone Number : 513-636-0800
Fax Number : 513-636-0823
Provider Business Practice Location Address
First Line : 3333 BURNET AVE
Second Line : ML 6015
City : CINCINNATI
State : OH
Zip : 45229-3039
Country : US
Telephone Number : 513-636-0800
Fax Number : 513-636-0823
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 05/06/2010

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