MEDICARE: LYNN H SAMUEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZB0001X	Blood Banking & Transfusion Medicine Physician	0101044708	VA
2	207ZC0500X	Cytopathology Physician	0101044708	VA
3	207ZH0000X	Hematology (Pathology) Physician	0101044708	VA
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	0101044708	VA
5	207ZP0104X	Chemical Pathology Physician	0101044708	VA
6	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	0101044708	VA
7	207ZP0213X	Pediatric Pathology Physician	0101044708	VA
8	207PE0005X	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	0101044708	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00757523	OTHER	VA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013906627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN H SAMUEL MD

Provider Business Mailing Address
First Line	:	1560 CHAPMAN RD
Second Line	:
City	:	STANARDSVILLE
State	:	VA
Zip	:	22973-3620
Country	:	US
Telephone Number	:	540-316-5604
Fax Number	:	540-316-5601

Provider Business Practice Location Address
First Line	:	493 BLACKWELL RD
Second Line	:	SUITE 101A
City	:	WARRENTON
State	:	VA
Zip	:	20186-2628
Country	:	US
Telephone Number	:	540-316-5604
Fax Number	:	540-316-5601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	05/27/2014

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Directions to “ LYNN H SAMUEL MD” Practice Location

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