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General NPI Number Information
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NPI Number | 1912964586
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Entity Type | Individual
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Provider Name | SAMUEL T RAWLS MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 3008A S FLETCHER AVE
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-4597
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Country | US
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Telephone | 912-270-1981
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Fax | 904-530-2296
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Provider Business Mailing Address
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Address Line | 3008-A S. FLETCHER AVE.
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-4597
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Country | US
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Telephone | 912-270-1981
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Fax | 904-530-2296
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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 | ME139183
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License Number State | FL
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