Individual
JERMALE SAM
Active
Individual
JERMALE SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
Q5557
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349593901
—
TX
01
—
8FN447
BCBS
TX
01
—
P01580991
RR MEDICARE
TX
Enumeration date
07/27/2010
Last updated
10/10/2023
Update your record
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