Organization
AYAZ SAMANDANI MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYAZ M SAMADANI MD (MD/OWNER)
(920) 887-7731
Entity
Organization
Contact information
Practice address
215 CORPORATE DR, SUITE H, BEAVER DAM, WI 53916-3123
(920) 887-7731
(920) 887-3201
Mailing address
215 CORPORATE DR, SUITE H, BEAVER DAM, WI 53916-3123
(920) 887-7731
(920) 887-3201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/30/2014
Last updated
05/30/2014
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