Healthcare Provider Details

I. General information

NPI: 1710077425
Provider Name (Legal Business Name): SAMANTHA ROBIN LEAPER HS, USCG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C O M D T /C G 1122/ U S COAST GUARD 2100 2ND ST SW, SUITE 5314
WASHINGTON DC
20593-0001
US

IV. Provider business mailing address

196 TRADD ST
CHARLESTON SC
29401-1800
US

V. Phone/Fax

Practice location:
  • Phone: 202-267-0801
  • Fax:
Mailing address:
  • Phone: 843-724-7653
  • Fax: 843-724-7655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: