MEDICARE: SAMIRA LATAVIA BAYLOR

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	104100000X	Social Worker		VA

General Provider Information

NPI Number	:	1699632729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIRA LATAVIA BAYLOR

Provider Business Mailing Address
First Line	:	100 NEW RIVER DR APT H
Second Line	:
City	:	RADFORD
State	:	VA
Zip	:	24141-1867
Country	:	US
Telephone Number	:	540-250-5150
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 ROANOKE ST STE 1
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-2512
Country	:	US
Telephone Number	:	540-322-3040
Fax Number	:	540-394-7105

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

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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Directions to “ SAMIRA LATAVIA BAYLOR ” Practice Location

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