Individual
ANGELITO L SAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 FRANKFORT RD STE 101, SHELBYVILLE, KY 40065-7401
(502) 647-5468
(502) 647-7134
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
29789
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300056797
—
IN
05
—
64297898
—
KY
01
—
K140311
MEDICARE
KY
Enumeration date
09/26/2006
Last updated
09/21/2022
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