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General NPI Number Information
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NPI Number | 1134199557
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Entity Type | Individual
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Provider Name | SAMUEL P ENG MD
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Gender | Male
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 10/12/2009
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Provider Practice Location Address
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Address Line | 18111 PRINCE PHILIP DR SUITE #207
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City | OLNEY
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State | MD
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Zip | 20832-1507
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Country | US
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Telephone | 301-774-7170
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Fax | 301-774-6676
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Provider Business Mailing Address
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Address Line | 18111 PRINCE PHILIP DR SUITE #207
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City | OLNEY
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State | MD
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Zip | 20832-1507
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Country | US
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Telephone | 301-774-7170
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Fax | 301-774-6676
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0050207
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License Number State | MD
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