Healthcare Provider Details

I. General information

NPI: 1093799165
Provider Name (Legal Business Name): JAMES BUCHANAN SAMPSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-5638
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889-5638
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-7895
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberC128526
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberL3462
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: