Healthcare Provider Details

I. General information

NPI: 1568463800
Provider Name (Legal Business Name): JAMES LEE SAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 ARGYLE STREET
SANDUSKY MI
48471
US

IV. Provider business mailing address

PO BOX 77000
DETROIT MI
48277-2000
US

V. Phone/Fax

Practice location:
  • Phone: 810-648-3229
  • Fax: 810-648-5404
Mailing address:
  • Phone: 586-447-4171
  • Fax: 586-447-4180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301069270
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: