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General NPI Number Information
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NPI Number | 1447860762
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Entity Type | Individual
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Provider Name | SAMIYAH SADULLAH MD
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Gender | Female
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Dates
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Enumeration Date | 08/01/2020
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 2900 1ST AVE RM 1025
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City | HUNTINGTON
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State | WV
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Zip | 25702-1241
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Country | US
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Telephone | 304-399-7484
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Fax | 304-399-7579
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Provider Business Mailing Address
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Address Line | 48 W 138TH ST APT 5J
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City | NEW YORK
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State | NY
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Zip | 10037-1791
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Country | US
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Telephone | 646-220-1338
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 32388
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License Number State | WV
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