Individual
MR. DERICK NGUFOR SAMAFUHBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
315 W 15TH ST, LIBERAL, KS 67901-2455
(620) 629-6477
(620) 629-6651
Mailing address
PO BOX 1215, ATTN CLINIC BILLING OFFICE, LIBERAL, KS 67905-1215
(620) 629-6638
(620) 629-6684
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110005063
VA
363A00000X
Physician Assistant
024081-01
NY
363A00000X
Physician Assistant
Primary
1501801
KS
363A00000X
Physician Assistant
8803
GA
363A00000X
Physician Assistant
PA2321
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200631770A
—
OK
05
—
201134920A
—
KS
Enumeration date
01/22/2015
Last updated
11/10/2025
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