Individual
SAMUEL C DURSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5501 HOPKINS BAYVIEW CIR, BALTIMORE, MD 21224-6821
(410) 550-4057
Mailing address
PO BOX 64264, BALTIMORE, MD 21264-4264
(410) 550-0925
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D47040
MD
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
D47040
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371681300
—
MD
Enumeration date
05/30/2006
Last updated
02/06/2013
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