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NPI Code Detail

MEDICARE: MARIA SAMUEL MD

MEDICARE: MARIA 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
1207RG0100XGastroenterology Physician23898ND
2207RG0100XGastroenterology Physician70700WI
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1417274218
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA SAMUEL MD
Provider Business Mailing Address
First Line : 200 1ST ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55905-0001
Country : US
Telephone Number : 715-838-5222
Fax Number :
Provider Business Practice Location Address
First Line : 1400 BELLINGER ST
Second Line :
City : EAU CLAIRE
State : WI
Zip : 54703-5222
Country : US
Telephone Number : 715-838-5222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2010
Last Update Date : 02/15/2026

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