Individual
DR. JEFFREY NEIL SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1414 WOODLAND AVE, DULUTH, MN 55803-2624
(218) 302-1000
Mailing address
1414 WOODLAND AVE, DULUTH, MN 55803-2624
(952) 898-1600
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
40515
MN
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
40515
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
860217400
—
MN
Enumeration date
12/29/2006
Last updated
10/13/2020
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