Gordan Samoukovic, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301105602 Issued in MI

Practice address

1500 E Medical Center Drive
3Rd Floor Cardiovascular Center Recp C
Ann Arbor, MI 48109-5864

Phone

(888) 287-1082

NPI assigned

Sep 29, 2014

Last updated

Oct 2, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1659774172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "address_2": "3RD FLOOR CARDIOVASCULAR CENTER RECP C",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095864",
            "telephone_number": "888-287-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMOUKOVIC",
        "first_name": "GORDAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301105602",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MI",
            "license": "4301105602",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samaritas
• Shardha Rachelle Samaroo, NP
• Sindhu N Samba, MD
• Elias Anthony Samona, DO
• Kathryn A Samoray, CRNA
• Jennifer Sampson, B.S., CNIM
• Woodrow James Sams, MD
• Imelda Binarao Samsundar
• Michal Samuel, MSW MA
• Shani Samuel, LLMSW

• Surgery Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.