MEDICARE: SAMANTHA STEGER SMITH PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	363A00000X	Physician Assistant	5601011583	MI

General Provider Information

NPI Number	:	1003579103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA STEGER SMITH PA-C

Provider Business Mailing Address
First Line	:	2417 CHESLEY DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4831
Country	:	US
Telephone Number	:	248-795-3132
Fax Number	:

Provider Business Practice Location Address
First Line	:	37000 GRAND RIVER AVE
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48335-2868
Country	:	US
Telephone Number	:	248-536-2127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2021
Last Update Date	:	03/13/2023

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