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Organization
SAMRAJ MEDICAL CLINIC, P.C.
Active
Organization
SAMRAJ MEDICAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA S SAMRAJ MD (PRESIDENT)
(706) 653-2226
Entity
Organization
Contact information
Practice address
2000 12TH AVE, COLUMBUS, GA 31901-1638
(706) 653-2226
(706) 653-2228
Mailing address
2000 12TH AVE, COLUMBUS, GA 31901-1638
(706) 653-2226
(706) 653-2228
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
046322
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000880558C
—
GA
01
—
297594
WELLCARE
GA
01
—
923658
BCBS
GA
01
—
DD4216
MEDICARE RAILROAD CARRIER
FL
01
—
GRP7206
MEDICARE GROUP ID
GA
01
—
P00226966
RR MEDICARE
GA
Enumeration date
10/31/2007
Last updated
03/31/2023
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