Sampson, Shane Timothy

Sampson, Shane Timothy is an individual health care provider with primary practice located at 1989 Miamisburg Centerville Rd Ste 301 , Centerville OH 45459-3858. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sampson, Shane Timothy can be contacted via phone (937) 434-7353.

Contact Information

Primary practice address
1989 Miamisburg Centerville Rd Ste 301 Centerville OH 45459-3858
Phone: (937) 434-7353
Fax: (937) 438-6569
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01038529 Indiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35063468 Ohio

Profile Details

NPI number 1023080116
LBN Legal business name Sampson, Shane Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Mar 1st, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023080116 NPPES
Ohio MEDICAID 0891343

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