National Provider Identifier
Samantha Jean Stallkamp Tidd, MD
Samantha Jean Stallkamp Tidd, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Rochester, NY and a listed phone number of (585) 275-1200.
Profile Overview
- NPI
- 1336992577
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- April 08, 2024
- Last Updated
- June 04, 2024
Practice Location
- 601 Elmwood Ave
- Rochester, NY 14642-0001
Phone: (585) 275-1200
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1336992577
- Entity Type
- Individual
- Last Name
- Tidd
- First Name
- Samantha
- Middle Name
- Jean Stallkamp
- Credential
- MD
- Provider Other Last Name
- Stallkamp
- Provider Other First Name
- Samantha
- Provider Other Middle Name
- Jean
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 601 Elmwood Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14642-0001
- Mailing Country
- US
- Mailing Phone
- (585) 756-4800
- Practice Street Address
- 601 Elmwood Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642-0001
- Practice Country
- US
- Practice Phone
- (585) 275-1200
- Practice Fax
- (585) 276-4013
- Enumeration Date
- April 08, 2024
- Last Updated
- June 04, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- June 04, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)