Provider Demographics
NPI:1013947241
Name:SANKARI, SAMAR RYIAD (MD)
Entity Type:Individual
Prefix:
First Name:SAMAR
Middle Name:RYIAD
Last Name:SANKARI
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 1:4605 MACCORKLE AVE SW
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1311
Mailing Address - Country:US
Mailing Address - Phone:304-414-4800
Mailing Address - Fax:
Practice Address - Street 1:1097 FLEDDERJOHN RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-4208
Practice Address - Country:US
Practice Address - Phone:304-720-1963
Practice Address - Fax:304-720-1966
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18512207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0079407000Medicaid
WV408848OtherCARELINK
WV5131643OtherUHC-ENDO
WV0079407000Medicaid
WV83108OtherUNICARE
WVP00314788OtherRR MEDICARE
WV4131643OtherUHC-INT. MED.
WV59927OtherCARELINK MEDICAID
WV8262195002OtherCIGNA
WVDE7709OtherRR MEDICARE
WV001803459OtherMSBCBS
WV9360461OtherGROUP MEDICARE FOR PROFESSIONAL ENDOCRINOLOGY ASSO
WV3810004642OtherMEDICAID GROUP PROFESSIONAL ENDOCRINOLOGY ASSOC
WV6062050OtherHEALTHSPRING
WV000023778OtherMSBCBS
WV203735449OtherUMWA COOPERATING
WV3810004642OtherMEDICAID GROUP PROFESSIONAL ENDOCRINOLOGY ASSOC
WVG43041Medicare UPIN
WVWV6019B441Medicare PIN