Provider Demographics
NPI:1871581611
Name:SAMARAS, CHRISTY JOY (DO)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:JOY
Last Name:SAMARAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:DESK R35
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-0293
Mailing Address - Fax:216-636-1937
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:DESK R35
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-0293
Practice Address - Fax:216-636-1937
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.009997207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2972494Medicaid
H97141Medicare UPIN
OH7420061Medicare PIN