Individual
SAMUEL K SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.N.P.
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-0241
Mailing address
22 S GREENE ST, BALTIMORE, MD 21201-1544
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R242089
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
R242089
MD
Other
Enumeration date
12/13/2015
Last updated
04/15/2020
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