Organization
LYNN H SAMUEL MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN H SAMUEL MD (OWNER)
(540) 316-5604
Entity
Organization
Contact information
Practice address
493 BLACKWELL ROAD, SUITE 101A, WARRENTON, VA 20186-2628
(540) 316-5604
(540) 316-5601
Mailing address
493 BLACKWELL ROAD, SUITE 101A, WARRENTON, VA 20186-2628
(540) 316-5604
(540) 316-5601
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
0101044708
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0101044708
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DP4396
RR MEDICARE
VA
Enumeration date
05/28/2009
Last updated
01/04/2010
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