Individual
SAMUEL IRAN VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1964 PATTERSON DR, GALESBURG, IL 61401-1434
(508) 334-1000
Mailing address
55 LAKE AVE N, WORCESTER, MA 01655-0002
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
03666440
IL
Other
Enumeration date
04/24/2017
Last updated
10/03/2023
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