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Individual

DR. BISHOY T SAMUEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15251 PLEASANT VALLEY RD, CENTER CITY, MN 55012-9640
(877) 793-5205
Mailing address
15251 PLEASANT VALLEY RD, CENTER CITY, MN 55012-9640
(877) 793-5205

Taxonomy

Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
0101274943
VA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
76576
MN
208D00000X
General Practice Physician
34453
AL
208D00000X
General Practice Physician
A148818
CA
208D00000X
General Practice Physician
T-3860
MS

Other

Enumeration date
05/20/2009
Last updated
06/21/2024
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