Individual
DR. SAMUEL PENNELLA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
607 SHELBY ST STE 700, DETROIT, MI 48226-3282
(908) 208-8926
Mailing address
14 GLENNON FARM LN, LEBANON, NJ 08833-4504
(908) 208-8926
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301510893
MI
208D00000X
General Practice Physician
68449
MN
208D00000X
General Practice Physician
DR.0074417
CO
208D00000X
General Practice Physician
TPME2986
FL
208D00000X
General Practice Physician
TW00059
KS
Other
Enumeration date
04/02/2018
Last updated
05/06/2026
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