MEDICARE: SAMUEL K ST CLAIR 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	207T00000X	Neurological Surgery Physician	39097	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	140006908	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	56219447701	OTHER	NC	TRICARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	97486	OTHER	NC	MEDCOST
4	706943	OTHER	NC	CHOICE CARE NETWORK
5	79535	OTHER	NC	BCBS NC
6	2070150	OTHER	NC	FIRST HEALTH
7	0650385	OTHER	NC	UNITED HEALTHCARE
8	4063806	OTHER	NC	AETNA

General Provider Information

NPI Number	:	1073588000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL K ST CLAIR MD

Provider Business Mailing Address
First Line	:	4201 LAKE BOONE TRL
Second Line	:	STE 202
City	:	RALEIGH
State	:	NC
Zip	:	27607-7512
Country	:	US
Telephone Number	:	919-235-0500
Fax Number	:	919-235-0505

Provider Business Practice Location Address
First Line	:	4207 LAKE BOONE TRL STE 220
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-6685
Country	:	US
Telephone Number	:	919-784-1410
Fax Number	:

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/09/2019

Similar Medicare Providers

1932174372 — ROBIN FREDERICK KOELEVELD MD
Practice Location Address:

4207 LAKE BOONE TRL STE 220
RALEIGH, NC
27607-6685

Practice Phone: 919-784-1410
Practice Fax:

1154345288 — DR. SIVAKUMAR JAIKUMAR MD
Practice Location Address:

4207 LAKE BOONE TRL STE 220
RALEIGH, NC
27607-6685

Practice Phone: 919-784-1410
Practice Fax:

1801019781 — DR. JOHN GRANT BUTTRAM JR. M.D.
Practice Location Address:

4207 LAKE BOONE TRL STE 220
RALEIGH, NC
27607-6685

Practice Phone: 919-784-1410
Practice Fax: 919-784-1409

1073738084 — HARTEJ SINGH SETHI MD
Practice Location Address:

4207 LAKE BOONE TRL STE 100
RALEIGH, NC
27607-6685

Practice Phone: 919-784-1410
Practice Fax:

1770784191 — ANGELA RENEE LIPSCOMB-HUDSON M.D.
Practice Location Address:

4207 LAKE BOONE TRL STE 210
RALEIGH, NC
27607-6685

Practice Phone: 919-784-7874
Practice Fax:

1750587036 — DR. JOHN A ENGLER M.D.
Practice Location Address:

4207 LAKE BOONE TRL STE 220
RALEIGH, NC
27607-6685

Practice Phone: 919-784-1410
Practice Fax:

Directions to “ SAMUEL K ST CLAIR MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.