Healthcare Provider Details

I. General information

NPI: 1932924248
Provider Name (Legal Business Name): AMJAD ALSAMTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E BROAD ST
RICHMOND VA
23298-5025
US

IV. Provider business mailing address

1200 E BROAD ST
RICHMOND VA
23298-5025
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9298
  • Fax:
Mailing address:
  • Phone: 804-828-9298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number0116040738
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: