Individual
DR. SAMUEL ALAN AMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 3RD AVE W STE 110, BRADENTON, FL 34205-8641
(941) 708-9555
(941) 708-5465
Mailing address
100 3RD AVE W STE 110, BRADENTON, FL 34205-8641
(941) 708-9555
(941) 708-5465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23587
OK
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
23587
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200521770A
—
OK
Enumeration date
05/24/2007
Last updated
05/12/2021
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