Provider Demographics
NPI:1265482871
Name:SAMAAN, ROBERT GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GEORGE
Last Name:SAMAAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 MACK RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-5379
Mailing Address - Country:US
Mailing Address - Phone:513-682-7273
Mailing Address - Fax:513-682-7253
Practice Address - Street 1:3050 MACK RD
Practice Address - Street 2:SUITE 305
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5379
Practice Address - Country:US
Practice Address - Phone:513-682-7273
Practice Address - Fax:513-682-7253
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071702207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2140829Medicaid
OHSA0835753Medicare ID - Type Unspecified
OH2140829Medicaid