Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 2213601 | NY |
N | 204F00000X | Transplant Surgeon | 4301111414 | MI |
Y | 208200000X | Surgeon | 4301111414 | MI |
Y | 208600000X | Surgeon | 4301111414 | MI |
NPI | 1164463733 |
---|---|
Provider Name | Benjamin Samstein |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02578412 | (05) | NY |