Basic Information
Provider Information
NPI: 1588645089
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NARAYAN
FirstName: SAMIR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5301 E. HURON RIVER DR.
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481060995
CountryCode: US
TelephoneNumber: 7347123596
FaxNumber:  
Practice Location
Address1: 5301 E HURON RIVER DR
Address2:  
City: YPSILANTI
State: MI
PostalCode: 481971051
CountryCode: US
TelephoneNumber: 7347123596
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/10/2005
LastUpdateDate: 06/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001X4301072308MIY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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