Healthcare Provider Details
I. General information
NPI: 1861657223
Provider Name (Legal Business Name): VALERIE GAY SAMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/25/2008
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
234 GOODMAN ST
CINCINNATI OH
45219-2364
US
IV. Provider business mailing address
PO BOX 636256
CINCINNATI OH
45263-6256
US
V. Phone/Fax
- Phone: 513-558-5661
- Fax: 513-475-7348
- Phone: 513-585-6200
- Fax: 513-245-3672
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 44883 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | 35PENDING |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: