Individual
SAMUEL E CARGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1818 COLE ST, ENUMCLAW, WA 98022-3504
(360) 802-5760
(360) 802-5799
Mailing address
1818 COLE ST, ENUMCLAW, WA 98022-3504
(360) 802-5760
(360) 802-5799
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00030972
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100012521
MEDICARE RAILROAD
WA
01
—
126528
STATE L&I
WA
01
—
126673
STATE L&I
WA
01
—
20042177
MEDICARE RAILROAD
WA
05
—
8147761
—
WA
Enumeration date
07/30/2006
Last updated
11/16/2010
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