MEDICARE: JAMES LEE SAMS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301069270	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568463800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES LEE SAMS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 77000
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48277-2000
Country	:	US
Telephone Number	:	586-447-4171
Fax Number	:	586-447-4180

Provider Business Practice Location Address
First Line	:	170 ARGYLE STREET
Second Line	:
City	:	SANDUSKY
State	:	MI
Zip	:	48471
Country	:	US
Telephone Number	:	810-648-3229
Fax Number	:	810-648-5404

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	02/24/2022

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