Healthcare Provider Details

I. General information

NPI: 1689425993
Provider Name (Legal Business Name): SAMANTHA STUDER NOWMOS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAMANTHA CHRISTINA STUDER D.O.

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 PHYSICIANS DR, PRISMA HEALTH CENTER FOR FAMILY MEDI SUITE A
GREER SC
29650
US

IV. Provider business mailing address

109 PHYSICIANS DR, PRISMA HEALTH CENTER FOR FAMILY MEDI SUITE A
GREER SC
29650
US

V. Phone/Fax

Practice location:
  • Phone: 864-797-9150
  • Fax:
Mailing address:
  • Phone: 864-797-9150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberLL92456
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberLL92456
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: