Individual
SAM GBUTUE VORKPOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
509 MEMORIAL DR STE 2, MANCHESTER, KY 40962-6196
(606) 598-8813
Mailing address
509 MEMORIAL DR STE 2, MANCHESTER, KY 40962-6196
(606) 598-8813
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101243487
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100054150
—
KY
Enumeration date
07/25/2007
Last updated
10/29/2013
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