Individual
DR. SAMUEL MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2011013600
MO
208600000X
Surgery Physician
46583
MN
208600000X
Surgery Physician
Primary
MD2018-0066
NM
2086S0102X
Surgical Critical Care Physician
2011013600
MO
2086S0127X
Trauma Surgery Physician
2011013600
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52656089
BNDD
MO
Enumeration date
07/20/2005
Last updated
06/11/2018
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