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NPI Code Detail

MEDICARE: DR. SUBHANKAR SAMAL MD

MEDICARE: DR. SUBHANKAR SAMAL 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
1207R00000XInternal Medicine Physician02998NC
2208000000XPediatrics Physician02998NC

Other Identifiers

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

General Provider Information

NPI Number : 1235368358
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUBHANKAR SAMAL MD
Provider Business Mailing Address
First Line : PO BOX 918025
Second Line :
City : ORLANDO
State : FL
Zip : 32891-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 W NORTHWOOD ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1324
Country : US
Telephone Number : 336-355-9696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2009
Last Update Date : 04/09/2024

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