Organization
MERVYN J. SAMUEL, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERVYN J. SAMUEL M.D. (OWNER)
(614) 882-4343
Entity
Organization
Contact information
Practice address
5910 CLEVELAND AVE., SUITE 100, COLUMBUS, OH 43231
(614) 882-4343
Mailing address
200 BRADENTON AVENUE, DUBLIN, OH 43017
(614) 793-1982
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35-03-5794-S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0238317
—
OH
Enumeration date
09/15/2006
Last updated
08/22/2020
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