Healthcare Provider Details

I. General information

NPI: 1689668238
Provider Name (Legal Business Name): DANIEL J SAMANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 05/09/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 VIA APPIA DR
SUNRISE BEACH MO
65079-5646
US

IV. Provider business mailing address

739 VIA APPIA DR
SUNRISE BEACH MO
65079-5646
US

V. Phone/Fax

Practice location:
  • Phone: 402-499-3100
  • Fax:
Mailing address:
  • Phone: 402-499-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number19688
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: