Healthcare Provider Details

I. General information

NPI: 1750812707
Provider Name (Legal Business Name): STEVEN ANDREW SAMBORSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S GERMANTOWN RD
GERMANTOWN TN
38138-2205
US

IV. Provider business mailing address

1400 S GERMANTOWN RD
GERMANTOWN TN
38138-2205
US

V. Phone/Fax

Practice location:
  • Phone: 901-759-3100
  • Fax: 901-759-3196
Mailing address:
  • Phone: 901-759-3100
  • Fax: 901-759-3196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA175341
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number69011
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: