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Individual

DR. RICHARD R SAMUEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8880 N HESS ST, SUITE 1, HAYDEN, ID 83835-8716
(208) 772-5204
(208) 772-5275
Mailing address
8880 N. HESS ST., SUITE 1, HAYDEN, ID 83835
(208) 772-5204
(208) 772-5275

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7185
ID

Other

Enumeration date
08/08/2006
Last updated
11/19/2008
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