MEDICARE: DR. SCOTT SAMI SAMONA 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
1	207XS0106X	Orthopaedic Hand Surgery Physician	4301101291	MI
2	208600000X	Surgery Physician	4301101291	MI
3	2086S0105X	Surgery of the Hand (Surgery) Physician	4301101291	MI

General Provider Information

NPI Number	:	1861736027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT SAMI SAMONA M.D.

Provider Business Mailing Address
First Line	:	11012 E 13 MILE RD STE 112
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48093-2546
Country	:	US
Telephone Number	:	586-573-6880
Fax Number	:

Provider Business Practice Location Address
First Line	:	22731 NEWMAN ST STE 100A
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2031
Country	:	US
Telephone Number	:	586-751-3880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2012
Last Update Date	:	05/19/2025

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