Provider Demographics
NPI:1437718889
Name:MEDANI, SAMAR (MBBS)
Entity Type:Individual
Prefix:DR
First Name:SAMAR
Middle Name:
Last Name:MEDANI
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DIVISION OF NEPHROLOGY., MEDICAL UNIV OF S CAROLINA
Mailing Address - Street 2:96 JONATHAN LUCAS STREET, ROOM 822, MSC 629
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425
Mailing Address - Country:US
Mailing Address - Phone:843-792-9188
Mailing Address - Fax:
Practice Address - Street 1:DIVISION OF NEPHROLOGY, MEDICAL UNIV OF SOUTH CAROLINA
Practice Address - Street 2:96 JONATHAN LUCAS STREET, ROOM 822, MSC 629
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425
Practice Address - Country:US
Practice Address - Phone:843-792-9188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6919820207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology