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General NPI Number Information
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NPI Number | 1144010752
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Entity Type | Organization
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Legal Business Name | PREMIER HEALTH PARTNERS PC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 30 N UNION RD STE 101
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5367
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Country | US
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Telephone | 716-710-7807
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Fax |
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Provider Business Mailing Address
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Address Line | 30 N UNION RD STE 101
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5367
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Country | US
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Telephone | 716-747-3262
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Fax | 716-710-7808
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Authorized Official
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Title or Position | DIRECTOR/SOLE SHAREHOLDER
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Name | SAMUEL CLOUD
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Credential | DO
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Telephone | 716-898-5779
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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