Healthcare Provider Details

I. General information

NPI: 1609552330
Provider Name (Legal Business Name): SAMANTHA LEUNG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 E CHESTNUT ST
AUGUSTA ME
04330-5758
US

IV. Provider business mailing address

149 NORTH ST
WATERVILLE ME
04901-4974
US

V. Phone/Fax

Practice location:
  • Phone: 207-623-6560
  • Fax: 207-623-6571
Mailing address:
  • Phone: 207-861-5000
  • Fax: 207-861-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO4326
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: