Individual
SAM G AMPORFUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
721 RIVERSIDE DRIVE LANE, MACON, GA 31201-2658
(478) 259-3439
(478) 254-2733
Mailing address
721 RIVERSIDE DRIVE LANE, MACON, GA 31201-2658
(478) 259-3439
(478) 254-2733
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
030940
GA
207Q00000X
Family Medicine Physician
Primary
030940
GA
208M00000X
Hospitalist Physician
030940
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000380619I
—
GA
05
—
000380619O
—
GA
05
—
000380619P
—
GA
01
—
030940
GA LICENSE
GA
01
—
202I083236
ACTIVE MEDICARE ID FOR URGENTONE
GA
05
—
GA1103
—
SC
Enumeration date
08/03/2006
Last updated
02/11/2025
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