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Individual

WILLIAM OLIVER SAMUELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2800 PIERCE ST, STE 101, SIOUX CITY, IA 51104
(712) 224-8677
(712) 277-1662
Mailing address
2800 PIERCE ST, STE 101, SIOUX CITY, IA 51104
(712) 224-8677
(712) 277-1662

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
26070
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00799078
MEDICARE RR
IA
Enumeration date
09/08/2006
Last updated
04/12/2010
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