Healthcare Provider Details

I. General information

NPI: 1619960614
Provider Name (Legal Business Name): SAMUEL HOWARD SADOW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 UNIVERSITY BLVD SUITE 200
JUPITER FL
33458-2778
US

IV. Provider business mailing address

PO BOX 2651
PALM BEACH FL
33480-2651
US

V. Phone/Fax

Practice location:
  • Phone: 877-395-6731
  • Fax: 561-627-2928
Mailing address:
  • Phone: 561-833-8663
  • Fax: 561-833-8663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME45344
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: