Individual
SAMANTHA C. MOERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
302 N INDEPENDENCE STREET, SUITE 600, ENID, OK 73701-4025
(580) 242-1300
(580) 237-7913
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(580) 242-1300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4317
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200118930A
—
OK
01
—
P00442024
RAILROAD MEDICARE
OK
Enumeration date
01/08/2007
Last updated
08/19/2019
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