Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 7079 | AZ |
NPI | 1144719642 |
---|---|
Provider Name | Samantha Odell Meyerhoff |
First Address | Chandler, AZ 85225-5493 |
Second Address | Chandler, AZ 85224-3619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2018 |
Last Update Date | 20/11/2021 |