Healthcare Provider Details

I. General information

NPI: 1366679912
Provider Name (Legal Business Name): JULIE B. SAMORA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE BALCH MD

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-2000
  • Fax:
Mailing address:
  • Phone: 614-722-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number257819
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number35099806
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number35-099806
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: