Individual
DEREK SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2451 FILLINGIM ST, MASTIN 102, MOBILE, AL 36617-2238
(251) 470-5890
(251) 471-7925
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 470-5890
(251) 471-7925
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME116198
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2008
Last updated
07/14/2014
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