Provider Demographics
NPI:1962661595
Name:MAST, SAMANTHA HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:HOWARD
Last Name:MAST
Suffix:
Gender:F
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:PO BOX 636406
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6406
Mailing Address - Country:US
Mailing Address - Phone:513-853-4749
Mailing Address - Fax:513-853-4740
Practice Address - Street 1:375 DIXMYTH AVE
Practice Address - Street 2:8TH FLOOR SETON CENTER
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2475
Practice Address - Country:US
Practice Address - Phone:513-862-6200
Practice Address - Fax:513-862-4358
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01088046A207VM0101X
KY44190207VM0101X
OH35091481207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35091481OtherLICENSE
OH2849314Medicaid
KY7100094650Medicaid