Provider Demographics
NPI:1992954150
Name:SAMAROO, TEJAS J (MD)
Entity type:Individual
Prefix:DR
First Name:TEJAS
Middle Name:J
Last Name:SAMAROO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5655 HUDSON DR STE 210
Mailing Address - Street 2:ARIS RADIOLOGY
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4455
Mailing Address - Country:US
Mailing Address - Phone:330-655-1869
Mailing Address - Fax:330-655-3828
Practice Address - Street 1:5655 HUDSON DR STE 210
Practice Address - Street 2:ARIS RADIOLOGY
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4455
Practice Address - Country:US
Practice Address - Phone:330-655-1869
Practice Address - Fax:330-655-3828
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0978862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1992954150Medicaid
OH623278OtherWELLCARE
PA1026800330001Medicaid
OH204881619259OtherCARESOURCE
OH0055856Medicaid
9639722OtherAETNA
MI1992954150Medicaid