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Individual

DR. SAM W RICHWINE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
1296 SIMS ST, SUITE B, GAINESVILLE, GA 30501-3850
(770) 534-1856
(770) 531-0355
Mailing address
1296 SIMS ST, SUITE B, GAINESVILLE, GA 30501-3850
(770) 534-1856
(770) 531-0355

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
019761
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00193498D
GA
Enumeration date
08/30/2006
Last updated
07/08/2007
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