Provider Demographics
NPI:1669551743
Name:JAMA, SAMUEL MWADKON (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:MWADKON
Last Name:JAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5140 RIVER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3764
Mailing Address - Country:US
Mailing Address - Phone:234-855-4778
Mailing Address - Fax:
Practice Address - Street 1:AMBASSADOR MEDICAL SERVICES
Practice Address - Street 2:432 NORTH AVE
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4105
Practice Address - Country:US
Practice Address - Phone:914-235-2137
Practice Address - Fax:914-237-2139
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2024-06-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY210991207R00000X
OH35.088098207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02203712Medicaid
NY02203712Medicaid
NYH56487Medicare UPIN