Individual
DR. DENNIS SAMUEL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 STEELES RD, BRISTOL, TN 37620-9532
(423) 844-4925
(423) 844-4933
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101050784
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
MD 27665
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01010057
—
VA
05
—
3802922
—
TN
Enumeration date
05/23/2005
Last updated
09/23/2009
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