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Individual

MS. SANDRA LEIGH SAMUELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2 BELLA GROVE DR, GREENVILLE, SC 29607-3459
(864) 603-5600
Mailing address
2 BELLA GROVE DR, GREENVILLE, SC 29607-3459

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12798087
CAQH
Enumeration date
10/07/2008
Last updated
08/26/2025
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