Individual
SAMANTHA NICOLE COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3414 OLANDWOOD CT, OLNEY, MD 20832-1384
(301) 774-0500
(301) 774-7338
Mailing address
3414 OLANDWOOD CT, OLNEY, MD 20832-1384
(301) 774-0500
(301) 774-7338
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C07752
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0007752
MARYLAND BOARD OF PHYSICIANS
MD
Enumeration date
10/23/2020
Last updated
07/18/2022
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