Provider Demographics
NPI:1821664483
Name:SAMADI, YASAMIN (MD, BS, BA)
Entity Type:Individual
Prefix:
First Name:YASAMIN
Middle Name:
Last Name:SAMADI
Suffix:
Gender:F
Credentials:MD, BS, BA
Other - Prefix:
Other - First Name:YASAMIN
Other - Middle Name:
Other - Last Name:SAMADI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, BS, BA
Mailing Address - Street 1:1600 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3656
Mailing Address - Country:US
Mailing Address - Phone:304-691-1100
Mailing Address - Fax:
Practice Address - Street 1:1600 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3656
Practice Address - Country:US
Practice Address - Phone:304-691-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X, 390200000X
VA116035619207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program