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General NPI Number Information
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NPI Number | 1265648810
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Entity Type | Individual
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Provider Name | SAMUEL MAGHUYOP MD
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | ELEMENT CARE/PACE 12 INGALLS COURT
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City | METHUEN
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State | MA
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Zip | 01844
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Country | US
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Telephone | 347-399-2878
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Fax |
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Provider Business Mailing Address
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Address Line | 151 TREMONT ST APT 8K
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City | BOSTON
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State | MA
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Zip | 02111-1107
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Country | US
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Telephone | 347-399-2878
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD12677
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD12677
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 018440
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 261597
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License Number State | MA
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