Provider Demographics
NPI:1932168242
Name:SAMSA, JOHN A (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:SAMSA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36100 EUCLID AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4456
Mailing Address - Country:US
Mailing Address - Phone:440-951-8360
Mailing Address - Fax:440-951-9408
Practice Address - Street 1:36100 EUCLID AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4456
Practice Address - Country:US
Practice Address - Phone:440-951-8360
Practice Address - Fax:440-951-9408
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-004943207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341313510JSOtherSUMMACARE
OH4335903OtherAETNA
OH0791611Medicaid
OH18958OtherQUALCHOICE
OH2597481OtherUNITED HEALTHCARE
OH000000209058OtherANTHEM
OH264168OtherFEDERAL BLACK LUNG
OH0791611Medicaid
OH341313510JSOtherSUMMACARE
OHSA4099043Medicare PIN