Organization
DEBRA C SAMS DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA C CRITES-SAMS DO (OWNER/PHYSICIAN)
(304) 645-4406
Entity
Organization
Contact information
Practice address
122 MAPLEWOOD AVENUE, RONCEVERTE, WV 24970
(304) 645-4406
Mailing address
PO BOX 465, RONCEVERTE, WV 24970
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E35409
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810010441
—
WV
Enumeration date
09/26/2007
Last updated
11/27/2007
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