Individual
MR. CHARLES M SAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6242 E ARBOR AVE, STE 111, MESA, AZ 85206-1309
(480) 610-8183
(480) 895-3110
Mailing address
6242 E ARBOR AVE, MESA, AZ 85206-1309
(480) 610-8183
(480) 089-5311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1554
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
578841
—
AZ
Enumeration date
04/26/2006
Last updated
07/08/2007
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