| Samson Ballesteros Md Llc | |
|
33001 Solon Rd 112 Solon OH 44139-2839 | |
| (440) 248-1297 | |
| (440) 349-7131 |
| Full Name | Samson Ballesteros Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 33001 Solon Rd, Solon, Ohio |
| Authorized Official Name and Position | Samson Ballesteros (OWNER) |
| Authorized Official Contact | 4402481297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samson Ballesteros Md Llc Po Box 22958 Cleveland OH 44122-0958 Ph: (216) 595-9600 | Samson Ballesteros Md Llc 33001 Solon Rd 112 Solon OH 44139-2839 Ph: (440) 248-1297 |
| NPI Number | 1518139849 |
|---|---|
| Provider Enumeration Date | 03/27/2008 |
| Last Update Date | 05/14/2014 |
| Medicare PECOS PAC ID | 1850432717 |
|---|---|
| Medicare Enrollment ID | O20140527000868 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518139849 | NPI | - | NPPES |
| 0671152 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Samson Ballesteros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548350978 PECOS PAC ID: 4789725631 Enrollment ID: I20100114000193 |
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