# MARTIN E. SAMUEL, DDS,MD,SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255582078
- **Authorized official:** MRS. JOYCE ROSE GRUNERT (ADMINISTRATOR)
- **Authorized official phone:** (414) 281-9824

## Contact information

- **Practice address:** 2741 W LAYTON AVE, SUITE 206, MILWAUKEE, WI 53221-2600
- **Practice address phone:** (414) 281-9824
- **Practice address fax:** (414) 281-9835
- **Mailing address:** 2741 W LAYTON AVE, SUITE 206, MILWAUKEE, WI 53221-2600
- **Mailing address phone:** (414) 281-9824
- **Mailing address fax:** (414) 281-9835

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/10/2008
- **Last updated:** 10/10/2008