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Individual

SAMUEL KEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(800) 422-8482
Mailing address
2003 N CROSSING WAY, DECATUR, GA 30033-4173
(540) 816-9164

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
82933
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/30/2014
Last updated
05/03/2019
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