MEDICARE: SAMANTHA MALAMET DO

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	207L00000X	Anesthesiology Physician	DO2546	NV

General Provider Information

NPI Number	:	1841685203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA MALAMET DO

Provider Business Mailing Address
First Line	:	7539 OLD COMPTON ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-6563
Country	:	US
Telephone Number	:	570-504-4932
Fax Number	:	702-473-5455

Provider Business Practice Location Address
First Line	:	7539 OLD COMPTON ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-6563
Country	:	US
Telephone Number	:	570-504-4932
Fax Number	:

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

Provider Enumeration Date	:	04/02/2015
Last Update Date	:	02/28/2020

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