Organization
DAVID L. SAMUEL, M.D. A PROFFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L SAMUEL M.D. (M.D.)
(985) 624-6650
Entity
Organization
Contact information
Practice address
233 SAINT ANN DR, SUITE 3, MANDEVILLE, LA 70471-3395
(985) 624-6650
(985) 674-3634
Mailing address
233 SAINT ANN DR, SUITE 3, MANDEVILLE, LA 70471-3395
(985) 624-6650
(985) 674-3634
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
10711R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1991562
—
LA
Enumeration date
06/22/2011
Last updated
06/22/2011
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