Individual
BANKOLE A. SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 LINCOLN STREET, 410, FRAMINGHAM, MA 01702
(508) 820-1650
(508) 872-2796
Mailing address
85 LINCOLN STREET, 410, FRAMINGHAM, MA 01702
(508) 820-1650
(508) 872-2796
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
270942
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110099405A
—
MA
Enumeration date
06/18/2011
Last updated
09/11/2020
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