Individual
DR. SAMUEL L PALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6500 JEFFERSON ST NE, SUITE 150, ALBUQUERQUE, NM 87109-3489
(602) 321-7056
Mailing address
37900 W PEORIA AVE, TONOPAH, AZ 85354-9336
(602) 321-7056
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
8620
AZ
207W00000X
Ophthalmology Physician
G50285
CA
207W00000X
Ophthalmology Physician
Primary
MD2007-0210
NM
Other
Enumeration date
06/01/2006
Last updated
07/08/2007
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