Provider Demographics
NPI:1528420700
Name:BARDEN, SAMANTHA ANN (MD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ANN
Last Name:BARDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ANN
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1246 W CHESTER PIKE STE 303
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-5683
Mailing Address - Country:US
Mailing Address - Phone:610-692-2605
Mailing Address - Fax:610-692-7310
Practice Address - Street 1:1246 W CHESTER PIKE STE 303
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-5683
Practice Address - Country:US
Practice Address - Phone:610-692-2605
Practice Address - Fax:610-692-7310
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD473164208000000X
NY299816208000000X
NY63753390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program