Individual
CATHERINE THYRA SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3920 ST FRANCIS WAY STE 100, LAFAYETTE, IN 47905-4917
(765) 428-5990
(765) 428-5896
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01065303A
IN
207V00000X
Obstetrics & Gynecology Physician
MD419761
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011054020003
—
PA
05
—
200913730
—
IN
Enumeration date
04/04/2006
Last updated
10/17/2023
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