Provider Demographics
NPI:1982647566
Name:SAMUEL, MILROY J (MD)
Entity Type:Individual
Prefix:DR
First Name:MILROY
Middle Name:J
Last Name:SAMUEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5888 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2860
Mailing Address - Country:US
Mailing Address - Phone:614-882-4343
Mailing Address - Fax:614-882-4664
Practice Address - Street 1:5910 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231
Practice Address - Country:US
Practice Address - Phone:614-882-4343
Practice Address - Fax:614-882-4664
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH350751462083A0300X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH33943Medicare UPIN