Organization
SAMANTHA C MOERY DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA C MOERY D.O. (PRESIDENT)
(580) 237-1877
Entity
Organization
Contact information
Practice address
3201 N VAN BUREN ST, 400, ENID, OK 73703-1800
(580) 237-1877
(580) 237-2872
Mailing address
3201 N VAN BUREN ST, 400, ENID, OK 73703-1800
(580) 237-1877
(580) 237-2872
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4317
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4317
STATE MEDICAL LICENSE
OK
01
—
P00442024
RAILROAD MEDICARE
OK
Enumeration date
04/23/2007
Last updated
04/20/2008
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