Individual
DR. DERICA NICOLE SAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3925 HARRISON RD STE 100, LOGANVILLE, GA 30052-5898
(770) 274-4222
(770) 284-3187
Mailing address
3925 HARRISON RD STE 100, LOGANVILLE, GA 30052-5898
(770) 274-4222
(770) 284-3187
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
227179
NC
2080P0206X
Pediatric Gastroenterology Physician
Primary
97229
GA
Other
Enumeration date
05/04/2017
Last updated
01/09/2025
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