MEDICARE: SAMUEL B. HUNTER, M.D. P.C

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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	0101023927	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	007403	OTHER	VA	ATHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558438739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMUEL B. HUNTER, M.D. P.C

Provider Business Mailing Address
First Line	:	1500 N 28TH ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-5332
Country	:	US
Telephone Number	:	804-225-1775
Fax Number	:	804-225-1788

Provider Business Practice Location Address
First Line	:	1500 N 28TH ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-5332
Country	:	US
Telephone Number	:	804-225-1775
Fax Number	:	804-225-1788

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SAMUEL BOYKIN HUNTER
Credential	:	M.D.
Telephone Number	:	804-225-1775

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	09/24/2007

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