Provider Demographics
NPI:1598716110
Name:GIDAY, SAMUEL ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ABRAHAM
Last Name:GIDAY
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 1:1817 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1853
Mailing Address - Country:US
Mailing Address - Phone:407-896-1726
Mailing Address - Fax:407-241-3259
Practice Address - Street 1:1817 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1853
Practice Address - Country:US
Practice Address - Phone:407-896-1726
Practice Address - Fax:407-241-3259
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD62848207RG0100X
DCMD034873207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI54241Medicare UPIN
DC154241Medicare UPIN
FLDP940YMedicare PIN