Provider Demographics
NPI:1497851547
Name:SAMANI, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:SAMANI
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 1:2222 S 16TH ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3796
Mailing Address - Country:US
Mailing Address - Phone:402-323-7260
Mailing Address - Fax:402-323-7266
Practice Address - Street 1:2222 S 16TH ST
Practice Address - Street 2:SUITE 240
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3796
Practice Address - Country:US
Practice Address - Phone:402-323-7260
Practice Address - Fax:402-323-7266
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18730174400000X
WI29298207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE57379OtherBCBS KS
KS100338080AMedicaid
KS100338080BMedicaid
NE900220OtherUHC
NE30253OtherBCBS NE
NE57379OtherBCBS KS
NE271431001Medicare PIN
NEB56260Medicare UPIN
KS100338080AMedicaid