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General NPI Number Information
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NPI Number | 1497175608
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Entity Type | Individual
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Provider Name | SAMUEL HAMNER GAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2014
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 5115 BERNARD DR
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City | ROANOKE
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State | VA
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Zip | 24018-4357
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Country | US
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Telephone | 540-345-0289
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13306
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City | ROANOKE
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State | VA
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Zip | 24032-3306
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Country | US
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Telephone | 540-345-0289
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101261338
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License Number State | VA
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