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NPI Code Detail

MEDICARE: EVLYN SAMUEL

MEDICARE: EVLYN SAMUEL
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
1207Q00000XFamily Medicine PhysicianTL.0011515CO

General Provider Information

NPI Number : 1154267482
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVLYN SAMUEL
Provider Business Mailing Address
First Line : 15503 E PRENTICE DR
Second Line :
City : CENTENNIAL
State : CO
Zip : 80015-4264
Country : US
Telephone Number : 303-748-4948
Fax Number :
Provider Business Practice Location Address
First Line : 777 BANNOCK ST
Second Line :
City : DENVER
State : CO
Zip : 80204-4597
Country : US
Telephone Number : 303-436-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2026
Last Update Date : 04/28/2026

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Directions to “ EVLYN SAMUEL ” Practice Location

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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.

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