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General NPI Number Information
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NPI Number | 1609066471
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Entity Type | Organization
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Legal Business Name | DAVID E SAMUEL DPM
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 196 WEST SPROUL ROAD SUITE 107
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City | SPRINGFIELD
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State | PA
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Zip | 19064
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Country | US
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Telephone | 610-328-9122
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Fax | 610-328-6219
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Provider Business Mailing Address
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Address Line | 196 WEST SPROUL ROAD SUITE 107
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City | SPRINGFIELD
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State | PA
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Zip | 19064
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Country | US
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Telephone | 610-328-9122
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Fax | 610-328-6219
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID EMANUAEL SAMUEL
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Credential | DPM
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Telephone | 610-328-9122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC003536L
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License Number State | PA
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