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General NPI Number Information
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NPI Number | 1558389783
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Entity Type | Individual
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Provider Name | SAMUEL E MONCURE III P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 7567 GREENBELT RD
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City | GREENBELT
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State | MD
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Zip | 20770-3403
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Country | US
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Telephone | 301-479-1008
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Fax | 240-616-2305
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | J1-0000936
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | J10000936
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | MD
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