Individual
DR. RUSSELL HOWARD SAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N CATTLEMEN RD, SUITE 220, SARASOTA, FL 34232-6410
(941) 371-6565
(941) 377-7731
Mailing address
600 N CATTLEMEN RD, SUITE 220, SARASOTA, FL 34232-6410
(941) 371-6565
(941) 377-7731
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME49137
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01494
BCBS
FL
05
—
063462000
—
FL
01
—
650501582
TAX ID
FL
01
—
770002753
MEDICARE RR
FL
Enumeration date
08/10/2005
Last updated
06/18/2015
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