Provider Demographics
NPI:1689668238
Name:SAMANI, DANIEL J (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
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 1:739 VIA APPIA DR
Mailing Address - Street 2:
Mailing Address - City:SUNRISE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65079-5646
Mailing Address - Country:US
Mailing Address - Phone:402-499-3100
Mailing Address - Fax:
Practice Address - Street 1:739 VIA APPIA DR
Practice Address - Street 2:
Practice Address - City:SUNRISE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65079-5646
Practice Address - Country:US
Practice Address - Phone:402-499-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19688207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE30932OtherBCBS
NE34178OtherBCBS
NE200022823OtherRAILROAD MEDICARE
KS30004803880001Medicaid
MO208973305Medicaid
NEP00794562OtherRAILROAD MEDICARE
NEF91927Medicare UPIN
NE266526Medicare ID - Type Unspecified