Individual
DR. SAMANTHA PULLIAM
Active
Individual
DR. SAMANTHA PULLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
2016-02241
NC
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
216990
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2007002
—
MA
01
—
J26321
BLUE CROSS
—
Enumeration date
10/21/2005
Last updated
05/17/2019
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