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NPI Code Detail

MEDICARE: SAMUEL S CALDWELL, MD

MEDICARE: SAMUEL S CALDWELL, 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
1207X00000XOrthopaedic Surgery Physician147389NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10069716OTHERGHI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000406955001OTHERBLUE SHIELD
485E121OTHERBLUE CROSS
5113749OTHERWELLCARE
618120OTHERMVP
72582OTHERCDPHP

General Provider Information

NPI Number : 1205021805
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAMUEL S CALDWELL, MD
Provider Business Mailing Address
First Line : 19 WEST AVE
Second Line : STE 102
City : SARATOGA SPRINGS
State : NY
Zip : 12866-6049
Country : US
Telephone Number : 518-584-0295
Fax Number : 518-584-0296
Provider Business Practice Location Address
First Line : 19 WEST AVE
Second Line : STE 102
City : SARATOGA SPRINGS
State : NY
Zip : 12866-6049
Country : US
Telephone Number : 518-584-0295
Fax Number : 518-584-0296
Authorized Official
Title or Position : OWNER
Name : SAMUEL S CALDWELL
Credential : MD
Telephone Number : 518-584-0295
Provider Enumeration Date : 09/07/2007
Last Update Date : 09/07/2007

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