Individual
MR. SAMUEL DAVID LICATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4000 JOHNSON RD, 2ND FLOOR, STEUBENVILLE, OH 43952-2364
(740) 266-5959
(740) 266-5957
Mailing address
380 SUMMIT AVE, MSO PHYSICIAN BILLING, STEUBENVILLE, OH 43952-2667
(740) 283-7776
(740) 283-7807
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
18107
WV
208600000X
Surgery Physician
Primary
35064482
OH
208600000X
Surgery Physician
MD048163L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015319490002
—
PA
05
—
0126291000
—
WV
05
—
0188381
—
OH
Enumeration date
09/23/2005
Last updated
12/11/2025
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