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NPI Code Detail

MEDICARE: SAMUEL WAKELIN

MEDICARE:   SAMUEL  WAKELIN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1427905298
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL WAKELIN
Provider Business Mailing Address
First Line : 1420 CENTRE AVE APT 2015
Second Line :
City : PITTSBURGH
State : PA
Zip : 15219-3535
Country : US
Telephone Number : 978-549-5568
Fax Number :
Provider Business Practice Location Address
First Line : 3900 RESERVOIR RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20007-2126
Country : US
Telephone Number : 978-549-5568
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2026
Last Update Date : 03/11/2026

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Directions to “ SAMUEL WAKELIN ” Practice Location

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