Healthcare Provider Details

I. General information

NPI: 1225779507
Provider Name (Legal Business Name): JENNIFER KATHERINE SAMIEC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 N HAMILTON RD STE 3C
WESTERVILLE OH
43081-2062
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-7500
  • Fax: 614-685-9427
Mailing address:
  • Phone: 614-293-7500
  • Fax: 614-685-9427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.156914
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: