Provider Demographics
NPI:1174342661
Name:DIAW, SAMBA
Entity type:Individual
Prefix:
First Name:SAMBA
Middle Name:
Last Name:DIAW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 ASHBURN RD APT E
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3700
Mailing Address - Country:US
Mailing Address - Phone:513-257-4881
Mailing Address - Fax:
Practice Address - Street 1:593 ASHBURN RD APT E
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3700
Practice Address - Country:US
Practice Address - Phone:513-257-4881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health