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General NPI Number Information
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NPI Number | 1609239003
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Entity Type | Individual
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Provider Name | DAVID SAMUEL MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 3349 RTE 138 STE F
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City | WALL TOWNSHIP
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State | NJ
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Zip | 07719-9671
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Country | US
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Telephone | 732-280-5464
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Fax | 732-280-5443
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Provider Business Mailing Address
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Address Line | 1120 NW 14TH ST STE 610-3
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City | MIAMI
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State | FL
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Zip | 33136-2107
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME145611
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA12301300
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 25MA12301300
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License Number State | NJ
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