Organization
MARTIN E. SAMUEL, DDS,MD,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOYCE ROSE GRUNERT (ADMINISTRATOR)
(414) 281-9824
Entity
Organization
Contact information
Practice address
2741 W LAYTON AVE, SUITE 206, MILWAUKEE, WI 53221-2600
(414) 281-9824
(414) 281-9835
Mailing address
2741 W LAYTON AVE, SUITE 206, MILWAUKEE, WI 53221-2600
(414) 281-9824
(414) 281-9835
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30307900
—
WI
Enumeration date
10/10/2008
Last updated
10/10/2008
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