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Individual

ATTIQUE SAMDANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1401 JOHNSTON WILLIS DR, STE 100, RICHMOND, VA 23235-4730
(804) 330-7990
(804) 330-2701
Mailing address
7202 GLEN FOREST DR, SUITE 200, RICHMOND, VA 23226-3781
(804) 673-0134
(804) 673-1796

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0101057790
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005868718
VA
01
237403
ANTHEM BCBS VA
VA
01
C01120
MEDICARE GROUP PTAN
VA
01
C06287
MEDICARE GROUP PTAN
VA
Enumeration date
04/10/2006
Last updated
05/21/2021
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