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Individual

DR. SAMUEL WINFRED PERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
2020 WAKEFIELD AVE, PETERSBURG, VA 23805-2112
(804) 732-1211
(804) 733-5946
Mailing address
2020 WAKEFIELD AVE, PETERSBURG, VA 23805-2112
(804) 732-1211
(804) 733-5946

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
0103000377
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9331409
VA
Enumeration date
05/27/2005
Last updated
07/08/2007
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