MEDICARE: DR. PRIYA SAMANT DPM

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	213E00000X	Podiatrist	5901002544	MI
2	213ES0103X	Foot & Ankle Surgery Podiatrist	003795	OH
3	213E00000X	Podiatrist	2039	NV

General Provider Information

NPI Number	:	1770997405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRIYA SAMANT DPM

Provider Business Mailing Address
First Line	:	2208 WHITE MIST DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-0118
Country	:	US
Telephone Number	:	510-579-7797
Fax Number	:

Provider Business Practice Location Address
First Line	:	3175 SAINT ROSE PKWY STE 320
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3508
Country	:	US
Telephone Number	:	702-997-9833
Fax Number	:	702-666-0413

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

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	09/17/2021

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Directions to “ DR. PRIYA SAMANT DPM” Practice Location

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