Individual
DR. GEORGE P SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 HOSPITAL DR, DONIPHAN, MO 63935-1274
(573) 996-7148
(573) 996-4041
Mailing address
PO BOX 989, POPLAR BLUFF, MO 63902-0989
(573) 778-0020
(573) 776-7548
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R5B21
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188260
BLUE CROSS BLUE SHIELD
MO
05
—
201563616
—
MO
Enumeration date
04/18/2006
Last updated
02/28/2012
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