Organization
S SAMUEL IM MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUNGGEUN SAMUEL IM M.D. (OWNER)
(269) 969-6211
Entity
Organization
Contact information
Practice address
485 E COLUMBIA AVE, SUITE 11 A, BATTLE CREEK, MI 49014-5499
(269) 969-6211
(269) 969-6049
Mailing address
485 E COLUMBIA AVE, SUITE 11 A, BATTLE CREEK, MI 49014-5499
(269) 969-6211
(269) 969-6049
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301031469
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1077038
—
MI
Enumeration date
02/10/2010
Last updated
02/10/2010
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