Ayaz Samandani MD SC

Organization Active NPI Family Medicine Physician · Beaver Dam, WI

NPI 1205248804 · NPPES record last updated May 30, 2014

Key facts

NPI
1205248804
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
AYAZ SAMANDANI MD SC
Practice address
215 Corporate Dr
Suite H
Beaver Dam, WI 53916-3123
Phone
(920) 887-7731
Fax
(920) 887-3201
NPI assigned
May 30, 2014
Organization subpart
No

Authorized official

Name
Ayaz M Samadani, MD
Title
MD/Owner
Phone
(920) 887-7731

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

215 Corporate Dr
Suite H
Beaver Dam, WI 53916-3123

Mailing address

215 Corporate Dr
Suite H
Beaver Dam, WI 53916-3123
Phone (920) 887-7731

Other providers in Beaver Dam, WI

All providers in Beaver Dam, WI · Family Medicine Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.