Organization
SAM CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONY N VANBANG MD (OWNER/MEDICAL DIRECTOR)
(720) 666-5116
Entity
Organization
Contact information
Practice address
1701 S FEDERAL BLVD, DENVER, CO 80219-4898
(720) 666-5116
(303) 934-4036
Mailing address
1701 S FEDERAL BLVD, DENVER, CO 80219-4898
(720) 666-5116
(303) 934-4036
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679747216
PERSONAL NPI NUMBER
CO
Enumeration date
02/11/2020
Last updated
02/11/2020
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