Individual
DR. DONALD SAMS BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-7999
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 265-7999
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
016875
GA
207L00000X
Anesthesiology Physician
Primary
ME104166
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000178428C
—
GA
05
—
001337800
—
FL
Enumeration date
10/28/2005
Last updated
09/25/2012
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