Individual
CHERYL SUSAN SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
841 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8329
(404) 862-4654
Mailing address
3110 WELLBROOK DR, LOGANVILLE, GA 30052-4996
(770) 862-8477
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12894
GA
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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