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General NPI Number Information
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NPI Number | 1821014861
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Entity Type | Individual
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Provider Name | SEAN A. SAMUELS D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 11/29/2012
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Provider Practice Location Address
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Address Line | 3701 OLD COURT RD STE 15A
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City | BALTIMORE
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State | MD
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Zip | 21208-3901
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Country | US
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Telephone | 443-660-8177
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Fax | 443-288-4009
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Provider Business Mailing Address
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Address Line | 2818 CHESWOLDE RD
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City | BALTIMORE
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State | MD
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Zip | 21209-3931
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Country | US
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Telephone | 443-955-3002
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Fax | 443-288-4009
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC23362
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 03495
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License Number State | MD
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