Individual
SAM C TUMMINELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19 SERGEANT PRENTISS DR, NATCHEZ, MS 39120-4727
(601) 442-8437
(601) 442-8442
Mailing address
19 SERGEANT PRENTISS DR, NATCHEZ, MS 39120-4727
(601) 442-8437
(601) 442-8442
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
11638
MS
207NS0135X
Procedural Dermatology Physician
11638
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018547
—
MS
05
—
1379999
—
LA
Enumeration date
08/12/2005
Last updated
08/31/2007
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