SAMRAJ MEDICAL CLINIC P.C. NPI 1780863324

NPI Information

  • NPI: 1780863324
  • Provider Name: SAMRAJ MEDICAL CLINIC, P.C.
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • CLIA Number: 11D0981803
  • Address: 2000 12TH AVE
    COLUMBUS, GA
    ZIP 31901
  • Phone: (706) 653-2226

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NPI Details

SAMRAJ MEDICAL CLINIC, P.C. is a medical specialty clinic center in Columbus, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). SAMRAJ MEDICAL CLINIC, P.C. NPI is 1780863324. The provider is registered as an organization entity type.

The provider's business location address is:

2000 12TH AVE
COLUMBUS, GA
ZIP 31901-638
Phone: (706) 653-2226
Fax: (706) 653-2228

The provider's authorized official is Joshua S Samraj .
The authorized official title is President and has the following contact phone number (706) 653-2226.

The CLIA number assigned to this NPI record is 11D0981803 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2007 and was last updated on 3/31/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical Specialty046322GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP7206OTHERGEORGIAMEDICARE GROUP ID
2297594OTHERGEORGIAWELLCARE
3P00226966OTHERGEORGIARR MEDICARE
4DD4216OTHERFLORIDAMEDICARE RAILROAD CARRIER
5000880558CMEDICAIDGEORGIA
6923658OTHERGEORGIABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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