Healthcare Provider Details

I. General information

NPI: 1033034301
Provider Name (Legal Business Name): SAMANTHA DONALDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 N SAGINAW RD
MIDLAND MI
48640-3350
US

IV. Provider business mailing address

133 N SAGINAW RD
MIDLAND MI
48640-3350
US

V. Phone/Fax

Practice location:
  • Phone: 989-631-0241
  • Fax: 989-835-9963
Mailing address:
  • Phone: 989-631-0241
  • Fax: 989-835-9963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: