Individual
MS. SAMANTHA DYAN POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
146 MONTGOMERY AVE STE 204, BALA CYNWYD, PA 19004-2956
(610) 206-3875
Mailing address
431 CAVERSHAM RD, BRYN MAWR, PA 19010-2901
(610) 220-8226
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD472573
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386910800
—
NY
Enumeration date
03/29/2012
Last updated
11/22/2021
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