Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 257819 | MA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 35099806 | OH |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 35-099806 | OH |
NPI | 1366679912 |
---|---|
Provider Name | Julie B. Samora |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2009 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0139366 | (05) | OH |
H402620 | CGS MEDICARE (01) | OH |