MEDICARE: DR. SAM PAUL GULINO 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
1	207ZP0101X	Anatomic Pathology Physician	MD210001618	DC
2	207ZF0201X	Forensic Pathology Physician	MD433710	PA

General Provider Information

NPI Number	:	1932867678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAM PAUL GULINO MD

Provider Business Mailing Address
First Line	:	2200 ARCH ST UNIT 901
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-1344
Country	:	US
Telephone Number	:	215-459-3508
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 MARKET ST FL 8
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-3527
Country	:	US
Telephone Number	:	646-484-8220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2021
Last Update Date	:	12/14/2021

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