Individual
MR. SAMUEL ANTHONY FARRAH II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
(681) 342-1000
Mailing address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
101295
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
73670
WV
390200000X
Student in an Organized Health Care Education/Training Program
73670
WV
Other
Enumeration date
10/04/2013
Last updated
03/17/2018
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