Individual
MR. SAMUEL ERNEST POTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
340 MEDICAL PKWY STE 250, GREER, SC 29650-2441
(864) 797-9480
(864) 797-9482
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016004684
IL
213E00000X
Podiatrist
Primary
766
SC
213ER0200X
Radiology Podiatrist
016004684
IL
213ES0131X
Foot Surgery Podiatrist
016004684
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230121
HEALTHLINK
—
01
—
480014432
PALMETTA GBA-RR MEDICARE
—
01
—
5805819
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/09/2006
Last updated
05/06/2024
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