MEDICARE: SAMANTHA NICOLE COURTNEY MD

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

General Provider Information

NPI Number	:	1881395184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA NICOLE COURTNEY MD

Provider Business Mailing Address
First Line	:	6788 VIENNA WOODS TRL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-1271
Country	:	US
Telephone Number	:	731-394-0330
Fax Number	:

Provider Business Practice Location Address
First Line	:	6788 VIENNA WOODS TRL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-1271
Country	:	US
Telephone Number	:	731-394-0330
Fax Number	:

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

Provider Enumeration Date	:	03/14/2023
Last Update Date	:	02/02/2026

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