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General NPI Number Information
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NPI Number | 1356520084
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Entity Type | Individual
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Provider Name | SAMUEL F MINOR MD
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Gender | Male
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 1890 S US HIGHWAY 131
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City | PETOSKEY
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State | MI
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Zip | 49770-8344
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Country | US
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Telephone | 231-487-6000
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Fax | 231-487-6014
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Provider Business Mailing Address
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Address Line | 1890 S US HIGHWAY 131
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City | PETOSKEY
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State | MI
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Zip | 49770-8344
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Country | US
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Telephone | 231-487-6000
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Fax | 231-487-6014
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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 | 4301058449
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License Number State | MI
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