Healthcare Provider Details

I. General information

NPI: 1437124021
Provider Name (Legal Business Name): MICHAEL A SAMOTOWKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FERRY RD
ATLANTA GA
30342-1606
US

IV. Provider business mailing address

PO BOX 1038
COLUMBUS GA
31902-1038
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-8000
  • Fax: 404-303-3759
Mailing address:
  • Phone: 706-649-6600
  • Fax: 706-649-6614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2023-02813
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number074898
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number14840
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number192458
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMD227334
License Number StateOR
# 6
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number00021026
License Number StateAL
# 7
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number00021026
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: