Healthcare Provider Details

I. General information

NPI: 1528272325
Provider Name (Legal Business Name): SAMIA TURNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 CROSS LANES DR
CROSS LANES WV
25313-1334
US

IV. Provider business mailing address

816 CROSS LANES DR
CROSS LANES WV
25313-1334
US

V. Phone/Fax

Practice location:
  • Phone: 304-776-1611
  • Fax: 304-776-0116
Mailing address:
  • Phone: 304-776-1611
  • Fax: 304-776-0116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22923
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: