Individual
SAMANTHA GRAVES SUFFREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
612 MOCKSVILLE AVE, SALISBURY, NC 28144-2732
(704) 210-5061
(704) 210-5337
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 210-5061
(704) 210-5337
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200600848
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5904474
—
NC
Enumeration date
07/03/2006
Last updated
06/06/2023
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