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General NPI Number Information
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NPI Number | 1083936413
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Entity Type | Individual
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Provider Name | MICHAEL A SAMUELS MD
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Gender | Male
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 615 N BONITA AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-3623
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Country | US
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Telephone | 850-769-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 CUMMINS DR
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City | MODESTO
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State | CA
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Zip | 95358-6405
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Country | US
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Telephone |
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01087742A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 74683
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 069345
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C194605
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME166081
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2020038348
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License Number State | MO
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