Individual
SAMUEL DAVID CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 BLUE SKY HWY, ETHETE, WY 82520
(307) 856-9281
Mailing address
363 SWEETWATER ST FL 2, LANDER, WY 82520-3347
(480) 221-5408
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14953A
WY
Other
Enumeration date
06/13/2019
Last updated
10/05/2022
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