Individual
LUIS SAMPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 NORTH COBB STREET, SUITE 230, MILLEDGEVILLE, GA 31061
(478) 453-9383
(478) 452-1147
Mailing address
750 NORTH COBB STREET, SUITE 230, MILLEDGEVILLE, GA 31061
(478) 453-9383
(478) 452-1147
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13713
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011822A
—
GA
01
—
52041050002
BCBS
GA
Enumeration date
10/14/2006
Last updated
07/12/2011
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