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General NPI Number Information
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NPI Number | 1083925523
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Entity Type | Individual
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Provider Name | ALEXANDER P SAMUEL M.D
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Gender | Male
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 111 N SOUTH ST 1ST FLOOR
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City | FARMVILLE
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State | VA
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Zip | 23901-1354
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Country | US
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Telephone | 443-392-3984
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Fax | 434-392-1038
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Provider Business Mailing Address
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Address Line | 111 N SOUTH ST 1ST FLOOR
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City | FARMVILLE
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State | VA
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Zip | 23901-1354
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Country | US
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Telephone | 443-392-3984
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Fax | 434-392-1038
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 0101247465
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License Number State | VA
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