Individual
DR. LORENZO KEITH SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 UNIVERSITY PKWY STE 2310, AIKEN, SC 29801-6835
(803) 648-1318
(803) 642-7803
Mailing address
367 S. GULPH RD, ATT: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(803) 648-1318
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
26694
SC
208600000X
Surgery Physician
K8468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145641002
—
TX
05
—
266946
—
SC
01
—
8H8817
BCBS
TX
Enumeration date
02/10/2006
Last updated
07/21/2022
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