Provider Demographics
NPI:1508855123
Name:SAMES, EDWARD L (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:L
Last Name:SAMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST
Mailing Address - Street 2:STE 800
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-633-3525
Mailing Address - Fax:502-633-8075
Practice Address - Street 1:515 HOSPITAL DR
Practice Address - Street 2:SUITE 1
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1640
Practice Address - Country:US
Practice Address - Phone:502-633-3525
Practice Address - Fax:502-633-8075
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY28754208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
0400341OtherUHC
KY48274OtherANTHEM
KY64287543Medicaid
KY48274OtherANTHEM
F29705Medicare UPIN
KYP400017482Medicare Oscar/Certification
KYP00848917Medicare PIN