Dr. Mautisum Samana, MD
Student in an Organized Health Care Education/Training Program in Saint Louis, MO. Individual provider (NPI-1).
NPI number1013841998
StatusActive
Last updated in NPPESJun 9, 2026
Details
- NPI
- 1013841998
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mautisum Samana
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 9, 2026
- Certification date
- Jun 9, 2026
- Last updated
- Jun 9, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
4590 Nash WaySaint Louis, MO 63110-1020
Phone 314-747-3000
Mailing address
4590 Nash WaySaint Louis, MO 63110-1020
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