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Individual
DR. SHELLEY DEBORAH SAMUEL
Active
Individual
DR. SHELLEY DEBORAH SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
199420
NY
207R00000X
Internal Medicine Physician
25MA07183800
NJ
207R00000X
Internal Medicine Physician
57248
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01920209
MEDICAID
NY
01
—
27N951
MEDICARE
NY
05
—
8598703
—
NJ
Enumeration date
03/15/2007
Last updated
06/04/2018
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