Provider Demographics
NPI:1326334616
Name:SAMAS, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:SAMAS
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 1:2408 PALOMINO DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4382
Mailing Address - Country:US
Mailing Address - Phone:646-750-2333
Mailing Address - Fax:864-476-0439
Practice Address - Street 1:130 OLD LARAMIE TRL
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-7014
Practice Address - Country:US
Practice Address - Phone:646-750-2333
Practice Address - Fax:864-476-0439
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2021-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281846208200000X, 208600000X
CODR.0063432208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery