Healthcare Provider Details

I. General information

NPI: 1427519248
Provider Name (Legal Business Name): SAMUEL BENJAMIN WOPPERER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 HOWELL RD
HAGERSTOWN MD
21740-6638
US

IV. Provider business mailing address

1733 HOWELL RD
HAGERSTOWN MD
21740-6638
US

V. Phone/Fax

Practice location:
  • Phone: 301-797-2525
  • Fax: 301-797-6927
Mailing address:
  • Phone: 301-797-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number71285
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0106072
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: