AYAZ M SAMADANI MD NPI 1811947088

NPI Information

  • NPI: 1811947088
  • Provider Name: AYAZ M SAMADANI, MD
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • Address: 215 CORPORATE DR
    SUITE H
    BEAVER DAM, WI
    ZIP 53916
  • Phone: (920) 887-7731

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NPI Details

Ayaz M Samadani, MD is a general practice in Beaver Dam, WI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Ayaz M Samadani, MD NPI is 1811947088. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

215 CORPORATE DR
SUITE H
BEAVER DAM, WI
ZIP 53916-123
Phone: (920) 887-7731

The enumeration date for this NPI number is 5/11/2006 and was last updated on 7/14/2014.

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
1208D00000XGeneral Practice20554-020WISCONSINYes

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
117209OTHERWISCONSINDEAN HEALTH INSURANCE
2080179057MEDICARE PINWISCONSIN
3008154375MEDICARE PINWISCONSIN
4007213215MEDICARE PINWISCONSIN
5B56258MEDICARE UPIN
631059600MEDICAIDWISCONSIN
71001259OTHERWISCONSINPHYSICIANS PLUS

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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