Provider Demographics
NPI:1184906331
Name:EVANS, SAMANTHA STEINER (AUD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:STEINER
Last Name:EVANS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:HOR T103
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-7191
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE # HORT103
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01879231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1678NOtherBCBSNC
9062828OtherAENTA
SCQ397595874OtherMEDICARE
NC3194104OtherCIGNA
771189OtherWELLCARE
3194104OtherCIGNA
SC30110580OtherSELECT HEALTH OF SC
SCSAN087Medicaid
NC3194104OtherCIGNA