Basic Information
| Provider Information | |||||||||
| NPI: | 1962820092 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAMTANI | ||||||||
| FirstName: | KARISHMA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 UNIVERSITY BLVD | ||||||||
| Address2: | |||||||||
| City: | BEAVERCREEK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453242640 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4100 W 3RD ST | ||||||||
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| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454289000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372457100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2014 | ||||||||
| LastUpdateDate: | 06/15/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35.131292 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.