Provider Demographics
NPI:1487685186
Name:WESTENSKOW, SAMUEL D (DO)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:D
Last Name:WESTENSKOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1087 DENNISON AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3201
Mailing Address - Country:US
Mailing Address - Phone:614-459-2906
Mailing Address - Fax:614-459-2932
Practice Address - Street 1:6520 WEST CAMPUS OVAL
Practice Address - Street 2:CENTRAL OHIO SURGICAL INSTITUTE
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054
Practice Address - Country:US
Practice Address - Phone:614-413-2233
Practice Address - Fax:614-413-2234
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008546207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2661169Medicaid
OH2661169Medicaid