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NPI Code Detail

MEDICARE: SAMANTHA JANE CRITES D.O.

MEDICARE: SAMANTHA JANE CRITES D.O.
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
1207RC0000XCardiovascular Disease PhysicianH0085969MD
2207RC0000XCardiovascular Disease Physician2566WV

General Provider Information

NPI Number : 1679898290
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA JANE CRITES D.O.
Provider Business Mailing Address
First Line : 3200 MACCORKLE AVE SE
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-1227
Country : US
Telephone Number : 304-388-5432
Fax Number :
Provider Business Practice Location Address
First Line : 3200 MACCORKLE AVE SE
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-1227
Country : US
Telephone Number : 304-388-5432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2010
Last Update Date : 12/02/2025

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