Individual
DEVPRAKASH SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3050 KRAFFT RD, FORT GRATIOT, MI 48059-3821
(810) 385-7700
(810) 385-7760
Mailing address
3050 KRAFFT RD, FORT GRATIOT, MI 48059-3821
(810) 385-7700
(810) 385-7760
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301055010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1307401332
BLUE CROSS BLUE SHIELD
MI
05
—
3385090
—
MI
Enumeration date
10/06/2006
Last updated
07/08/2007
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