Provider Demographics
NPI:1700312352
Name:SEARS, SAMANTHA A (MD)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:A
Last Name:SEARS
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 1:8240 NORTHCREEK DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2377
Mailing Address - Country:US
Mailing Address - Phone:513-246-7546
Mailing Address - Fax:513-246-5289
Practice Address - Street 1:8240 NORTHCREEK DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2377
Practice Address - Country:US
Practice Address - Phone:513-246-7546
Practice Address - Fax:513-246-5289
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY57162207N00000X
390200000X
OH35.149075207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100611530Medicaid