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Individual
DR. SAMUEL T THOMPSON
Active
Individual
DR. SAMUEL T THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01041048A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091692
ANTHEM PIN NUMBER
IN
01
—
100194370
MEDICAID GROUP NUMBER
IN
05
—
100343300
—
IN
01
—
1487680518
GROUP NPI
IN
01
—
200288740
MEDICAID GROUP NUMBER
IN
01
—
340012497
MEDICARE RAILROAD
IN
01
—
340012510
MEDICARE RAILROAD
IN
01
—
340012524
MEDICARE RAILROAD
IN
Enumeration date
07/31/2006
Last updated
09/16/2014
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