Individual
SAMANTHA LOUISE JACKSON-DILTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2301A FOREST DR, ANNAPOLIS, MD 21401-3833
(410) 266-6767
(410) 266-6761
Mailing address
1 HOLLOW LN STE 301, NEW HYDE PARK, NY 11042-1215
(516) 207-7851
(516) 207-7851
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
002952
GA
208000000X
Pediatrics Physician
0101269251
VA
208000000X
Pediatrics Physician
61798
TN
208000000X
Pediatrics Physician
Primary
D78881
MD
Other
Enumeration date
05/27/2008
Last updated
02/16/2022
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