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Individual

DR. SELYNE SAMUEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2300 MIAMI VALLEY DR STE 350, CENTERVILLE, OH 45459-1294
(937) 424-2469
(937) 424-2479
Mailing address
3170 KETTERING BLVD, BUILDING B 3RD FLOOR, MOMRAINE, OH 45439-1924
(937) 991-3188
(937) 223-9811

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35-128714
OH
2086X0206X
Surgical Oncology Physician
Primary
35.128714
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0167456
OH
01
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
07/22/2011
Last updated
01/19/2021
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