Individual
DR. SAM STAFFORD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
570 LONG POINT RD, SUITE 200, MT PLEASANT, SC 29464-7930
(843) 881-0320
(843) 881-5453
Mailing address
570 LONG POINT RD, SUITE 200, MT PLEASANT, SC 29464-7930
(843) 881-0320
(843) 881-5453
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
570943516
SC
207N00000X
Dermatology Physician
Primary
08579
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085794
—
SC
Enumeration date
05/02/2006
Last updated
10/24/2012
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