Individual
SAMUEL EDMOND FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 VAIL AVE STE 200, CHARLOTTE, NC 28207-1219
(704) 323-3668
(704) 323-3948
Mailing address
4601 PARK RD, STE 250, CHARLOTTE, NC 28209-2290
(704) 323-2237
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2020-00102
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316357940
—
NC
05
—
NC4198
—
SC
Enumeration date
05/05/2014
Last updated
08/10/2020
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